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Current Medical Science

, Volume 39, Issue 1, pp 99–110 | Cite as

Does Postoperative Rehabilitation for Radical Cystectomy Call for Enhanced Recovery after Surgery? A Systematic Review and Meta-analysis

  • Jun Xiao
  • Meng Wang
  • Wei He
  • Jing Wang
  • Fan Yang
  • Xue-you Ma
  • Yu Zang
  • Chun-guang Yang
  • Gan Yu
  • Zhi-hua WangEmail author
  • Zhang-qun Ye
Article
  • 8 Downloads

Abstract

The aim of this review was to systematically compare the outcomes of enhanced recovery after surgery (ERAS) with standard care (SC) after radical cystectomy. We performed a systematic search of PubMed, Ovid, Web of Science, and the Cochrane Library to identify studies published until September 2017 which involved a comparison of ERAS and SC. A meta-analysis was performed to assess the outcomes of ERAS versus SC. Sixteen studies including 8 prospective and 8 retrospective trials met the eligibility criteria. A total of 2100 participants were assigned to ERAS (1258 cases) or SC (842 cases). The time to first flatus passage {WMD=–0.95 days, 95% CI (–1.50,–0.41), P=0.0006}, time until return to a regular diet {WMD=–2.15 days, 95% CI (–2.86,–1.45), P<0.00001} and the length of hospital stay {WMD=–3.75 days, 95% CI (–5.13,–2.36), P<0.00001} were significantly shorter, and the incidence of postoperative complications {OR=0.60, 95% CI (0.44, 0.83), P=0.002}, especially postoperative paralytic ileus {OR=0.43, 95% CI (0.30, 0.62), P<0.00001} and cardiovascular complications {OR=0.28, 95% CI (0.09, 0.90), P=0.03} was significantly lower in the ERAS group than those in the SC group. This meta-analysis demonstrated that ERAS was associated with a shorter time to first flatus passage, return of bowel function, and the length of hospital stay than SC in patients undergoing radical cystectomy, as well as a lower rate of postoperative complications, especially paralytic ileus and cardiovascular complications.

Key words

enhanced recovery after surgery postoperative rehabilitation bladder cancer radical cystectomy meta-analysis 

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Copyright information

© Huazhong University of Science and Technology 2019

Authors and Affiliations

  • Jun Xiao
    • 1
  • Meng Wang
    • 2
  • Wei He
    • 1
  • Jing Wang
    • 1
  • Fan Yang
    • 1
  • Xue-you Ma
    • 1
  • Yu Zang
    • 1
  • Chun-guang Yang
    • 1
  • Gan Yu
    • 1
  • Zhi-hua Wang
    • 1
    Email author
  • Zhang-qun Ye
    • 1
  1. 1.Department of Urology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Nursing DepartmentHuanghuai UniversityZhumadianChina

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