| Objective:The advantages of the concept of enhanced recovery after surgery(ERAS)in various fields of surgery are obvious,but the application in perioperative management of gynecological ovarian cancer is still in the primary stage of exploration.This study explores the effectiveness and safety of ERAS concept in ovarian cancer by searching and analyzing relevant domestic and foreign literature,providing data support for subsequent clinical researchs.Methods:Using computer to search Chinese and English database,Chinese literatures selecte CNKI and Wanfang database to search,English literatures select Pub Med,Embase and Cochrane Library to seach,the searching time is from the establishment of the database to December2020.Strictly follow the inclusion and exclusion criteria to screen,sort documents and extract data,the extracted data uses Revman 5.3 software for statistical processing and analysis.The evaluation indicators include:the first exhaust time after operation,defecation time,first eating time,the rate of postoperative complications,length of hospital stay,the rate of readmission.According to different data types,it can be divided into dichotomous variables and continuous variables,among them,the rate of postoperative complications and the rate of readmission are dichotomous variables,using odds ratio(OR),95% confidence interval(CI)describe the results,the postoperative exhaust time,postoperative defecation time,postoperative eating time,length of hospital stay are continuous variables,using standardized mean difference(SMD),weighted mean difference(WMD)and 95% describe the results.Results:Finally,this study included 9 documents,including 6 Chinese literatures,3 foreign literatures,a total of 922 patiens were collected,including 462 in the ERAS group and 460 in the control group.The results as follows:1.the length of hospital stay in the ERAS group was shorter than that in the control group(WMD=-2.36,95%CI[-2.59,-2.13],P<0.00001),the difference was meaningful;2.the rate of readmission in the ERAS group was lower than that in the control group(OR=0.26,95%CI[0.09,0.74],P=0.01),the difference was statistically meaningful;3.in the subgroup that the postoperative exhaust time less than 3d subgroup,the exhaust time after operation in the ERAS group was earlier than that in the control group(SMD=-1.16,95%CI[-1.41,-0.91 ],P < 0.00001),the difference was meaningful;4.the first defecation time after operation in the ERAS group was earlier than that in the control group(WMD=-0.61,95%CI[-0.73,-0.48],P<0.00001),the difference was statistically meaningful;5.the first eating time after operation in the ERAS group was earlier than that in the control group(MD=-3.81,95%CI[-4.11,-3.51],P<0.00001),the difference was meaningful;6.the rate of total postoperative complications in the ERAS group was lower than that in the control group(OR=0.45,95%CI[0.31,0.66],P<0.0001),the difference was statistically meaningful;7.the rate of various complications: the rate of deep vein thrombosis in ERAS group was lower than that in the control group(OR=0.13,95%CI[0.02,0.73],P=0.02),the difference was statistically meaningful;the rate of incision infection,intestinal obstruction and abdominal distension were not statistically significant.Conclucion:1.The ERAS concept can shorten the first postoperative exhaust time,defecation time,first eating time for patiens with ovarian cancer.2.The ERAS concept can shorten the length of hospital stay,and declining the rate of readmission for patiens with ovarian cancer.3.The ERAS concept can decline the rate of the total postoperative complication for patiens with ovarian cancer,and decline the rate of deep vein thrombosis;the advantage of other complications still need to be futher studied.4.The application of the ERAS concept in the perioperative management in ovarian cancer is safe and effective,but the results of this study have certain limitations.In the future,a large number of high-quality,multi-center,large-sample clinical controlled studies are stilled for further exploration. |
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