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Enhanced Recovery after Surgery (ERAS) Programs for Patients Having Colorectal Surgery: A Meta-analysis of Randomized Trials

  • Review Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Enhanced recovery after surgery programs have been introduced with aims of improving patient care, reducing complication rates, and shortening hospital stay following colorectal surgery. The aim of this meta-analysis was to determine whether enhanced recovery after surgery programs, when compared to traditional perioperative care, are associated with reduced primary hospital length of stay in adult patients undergoing elective colorectal surgery.

Methods

MEDLINE, EMBASE, the Cochrane Central Registry of Controlled Trials, and the reference lists were searched for relevant articles. Only randomized controlled trials comparing an enhanced recovery program with traditional postoperative care were included.

Results

Three of four included studies showed significantly shorter primary lengths of stay for patients enrolled in enhanced recovery programs. There was no significant difference in postoperative mortality when the two groups were compared [relative risk (RR) = 0.53; 95% CI = 0.12–2.38; test for heterogeneity, p = 0.40 and I 2 = 0], and patients in enhanced recovery programs were less likely to develop postoperative complications (RR = 0.61, 95% CI = 0.42–0.88; test for heterogeneity, p = 0.95 and I 2 = 0).

Authors’ Conclusions

There is some evidence to suggest that enhanced recovery after surgery programs are better than traditional perioperative care, but evidence from a larger, better quality randomized controlled trial is necessary.

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Acknowledgments

The authors would like to thank Dr. Prakesh Shah, Department of Pediatrics, University of Toronto, for his input during the conduct of the systematic review and preparation of the manuscript and Dr. Joseph Beyene, Department of Medicine, University of Toronto and Population Health Sciences Research Institute, Hospital for Sick Children for his input during the statistical analysis.

Author information

Authors and Affiliations

  1. Department of Surgery, University of Toronto, Toronto, Canada

    Cagla Eskicioglu, Shawn S. Forbes, Mary-Anne Aarts, Allan Okrainec & Robin S. McLeod

  2. Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada

    Cagla Eskicioglu, Shawn S. Forbes & Robin S. McLeod

  3. Zane Cohen Digestive Diseases Research Center, Mount Sinai Hospital, Toronto, Ontario, Canada

    Cagla Eskicioglu, Shawn S. Forbes & Robin S. McLeod

  4. Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada

    Robin S. McLeod

  5. Toronto East General Hospital, Toronto, Ontario, Canada

    Mary-Anne Aarts

  6. Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada

    Allan Okrainec

Authors
  1. Cagla Eskicioglu
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  2. Shawn S. Forbes
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  3. Mary-Anne Aarts
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  4. Allan Okrainec
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  5. Robin S. McLeod
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Corresponding author

Correspondence to Robin S. McLeod.

Additional information

No funding was sought for the conduct of this study; it is not based on a previous communication to a society or meeting.

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Eskicioglu, C., Forbes, S.S., Aarts, MA. et al. Enhanced Recovery after Surgery (ERAS) Programs for Patients Having Colorectal Surgery: A Meta-analysis of Randomized Trials. J Gastrointest Surg 13, 2321–2329 (2009). https://doi.org/10.1007/s11605-009-0927-2

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  • DOI: https://doi.org/10.1007/s11605-009-0927-2

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