| Objective :To systematically review the efficacy and safety of enhanced recovery after surgery in patients under going laparoscopic radical cystectomy.Menthods:Pubmed,Embase,Cochtane library,CNKI,VIP and wan fang datebase were searched from January 2001 to October 2018 for controlled clinical studies which involved enhanced recovery after surgery and conventional recovery after surgery.Two researchers independently filtered literature,extracted data and evaluated the menthodological quality of research papers.The mate-analysis was performed using the RevMan 5.3 sofetware.Results:A total of 16 related clinical studies were included,seven randomized and nine retrospective studies were analyzed,which consists of 1250 patients including ERAS group 638 cases,CRAS group 612 cases.The results of meta-analysis showed that ERAS was better than CRAS in the mean operative time(WMD=-1.96,95% CI-3.23~-0.69,P < 0.01)and in the length of postoperative hospital stay time(WMD=-4.68,95% CI-6.3~-3.06,P<0.01),The hospital cost was lower than CRAS(WMD=-0.97,95% CI-1.07~-0.88,P<0.01),Compared with the contral group,The time of anal exsufflation in postoperative patients(WMD=-1.18,95% CI-2.23~-0.13,P=0.03)? first return to bowel function(WMD=-5.44,95% CI-7.50~-3.37,P<0.01)and oral nutrition(WMD=-1.52,95% CI-2.31~-0.91,P<0.01)was shorter.The total incidence of postopetative complications was decreased(OR=-0.31,95% CI-0.22~-0.45,P<0.01);There was no significant difference in the volume of intraoperative blood and 30-day readmission rate(P>0.05).Conclusion:The effects of enhanced recovery after surgery in patients under going laparoscopic radical cystectomy was safe and effective.ERAS make the mean operative time shorter,as well as the length of postoperative hospital stay time,the first aerofluxus time and the leaving bed time.Moreover ERAS can also decrease the hospital cost and the total incidence of postopetative complications. |
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