Is ERAS Protocol Necessary during Ileostomy Reversal in Patients after Anterior Rectal Resection—A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion Process
- Age 18 years or older.
- Original clinical studies.
- Outcomes, including LOS, complication rate, mortality, or rehospitalization rate.
- End ileostomy or loop ileostomy closure.
- Incorrect publication type, i.e., meta-analysis, case report.
- Ileostomy reversal conducted as a part of a bigger procedure (e.g., liver resection due to metastases with concurrent ileostomy reversal).
- Missing information about the inclusion of the fast track/ERAS protocol elements (e.g., pre-op counseling, avoiding fasting, opioid-sparing analgesia, early ambulation, early post-op diet, etc.) in the study.
2.3. Extraction
2.4. Quality Assessment
2.5. Outcomes
2.6. Statistical Analysis
3. Results
3.1. Included Studies
3.2. ERAS Protocol
3.3. Complications
3.4. Readmissions
3.5. Length of Stay
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Author | Year | Country | Study Design | Mean Age (SD) in ERAS Group | Number of ERAS Patients | Mean Age (SD) in Control Group | Number of Control Patients |
---|---|---|---|---|---|---|---|
Bracey E | 2015 | UK | Cohort study | 63.6 (12.84) | 37 | 69.66 (12.04) | 108 |
Slieker J | 2018 | Switzerland | Case-control study | Median (Q1–Q3): 59 (48.5–68.5) | 69 | Median (Q1–Q3): 64 (52.5–70.8) | 48 |
Ottaviano K | 2020 | USA | Case-control study | 54.2 (15.7) | 59 | 51.1 (17.1) | 149 |
Pirzada MT | 2017 | Pakistan | Randomized controlled trial | 23.87 (4.56) | 30 | 27.80 (9.99) | 30 |
Raue W | 2008 | Germany | Non-randomized controlled trial | Median (Q1–Q3): 64.2 (29–75) | 20 | Median (Q1–Q3): 58.8 (25–73) | 20 |
Shen Y | 2023 | China | Case-control study | Median (Q1–Q3): 55 (15–65) | 213 | Median (Q1–Q3): 62 (35–83) | 136 |
Study | Preoperative Counseling | Preoperative Carbohydrate Loading | Antithrombotic Prophylaxis | Antibiotic Prophylaxis | Laparoscopic Surgery | Balanced Intravenous Fluid Therapy | No Nasogastric Tubes Left Postoperatively |
---|---|---|---|---|---|---|---|
Bracey E 2015 | Yes | No | No | No | No | Yes | No |
Slieker J 2018 | Yes | Yes | No | No | Yes | Yes | No |
Ottaviano K 2020 | Yes | Yes | No | No | Yes | No | No |
Pirzada MT 2017 | Yes | Yes | No | Yes | Yes | Yes | Yes |
Raue W 2008 | Yes | Yes | No | Yes | Yes | Yes | Yes |
Shen Y 2023 | Yes | No | No | Yes | Yes | No | No |
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Kisielewski, M.; Stefura, T.; Rusinek, J.; Zając, M.; Pisarska-Adamczyk, M.; Richter, K.; Wojewoda, T.; Wysocki, W.M. Is ERAS Protocol Necessary during Ileostomy Reversal in Patients after Anterior Rectal Resection—A Systematic Review and Meta-Analysis. Gastroenterol. Insights 2024, 15, 720-729. https://doi.org/10.3390/gastroent15030051
Kisielewski M, Stefura T, Rusinek J, Zając M, Pisarska-Adamczyk M, Richter K, Wojewoda T, Wysocki WM. Is ERAS Protocol Necessary during Ileostomy Reversal in Patients after Anterior Rectal Resection—A Systematic Review and Meta-Analysis. Gastroenterology Insights. 2024; 15(3):720-729. https://doi.org/10.3390/gastroent15030051
Chicago/Turabian StyleKisielewski, Michał, Tomasz Stefura, Jakub Rusinek, Maciej Zając, Magdalena Pisarska-Adamczyk, Karolina Richter, Tomasz Wojewoda, and Wojciech M. Wysocki. 2024. "Is ERAS Protocol Necessary during Ileostomy Reversal in Patients after Anterior Rectal Resection—A Systematic Review and Meta-Analysis" Gastroenterology Insights 15, no. 3: 720-729. https://doi.org/10.3390/gastroent15030051