摘要
目的:系统评价加速康复外科(ERAS)理念在全胸腹腔镜联合食管癌根治术(TLE)中应用的安全性与有效性。方法:计算机检索从建库至2024年2月国内外数据库有关ERAS在TLE中应用的文献资料。对纳入文献采用RevMan 5.3软件进行Meta分析。结果:共纳入16篇文献、2036例患者,其中ERAS组1048例,常规组988例。Meta分析结果显示,与常规组相比,ERAS组首次下床时间更早(MD=-1.45,95%CI=-2.24~-0.66,P=0.0003),肛门排气时间更早(MD=-0.81,95%CI=-1.02~-0.60,P<0.00001),胸腔引流管拔除时间更短(MD=-3.17,95%CI=-4.92~-1.41,P=0.0004),住院时间更短(MD=-3.45,95%CI=-4.39~-2.52,P<0.00001),住院费用更低(MD=-0.73,95%CI=-1.01~-0.44,P<0.00001),术后总并发症发生率更低(OR=0.42,95%CI=0.27~0.65,P=0.0001)。结论:TLE围手术期应用ERAS是安全、有效的,可促进患者快速康复。
Objective:To evaluate the safety and efficacy of the enhanced recovery after surgery(ERAS)concept in totally thoracoscopic-laparoscopic esophageal cancer radical surgery(TLE)using a systematic meta-analysis approach.Methods:The literature data on the application of ERAS in TLE from domestic and foreign databases were retrieved by computer from the inception of the database to Feb.2024.Meta-analysis was performed on the included studies using RevMan 5.3 software.Results:A total of 16 articles were included,with a total of 2036 patients,including 1048 in the ERAS group and 998 in the conventional group.The meta-analysis r esults showed that compared with the conventional group,the ERAS group had a earlier ambulation time(MD=-1.45,95%CI=-2.24~-0.66,P=0.0003),earlier time to first flatus(MD=-0.81,95%CI=-1.02~-0.60,P<0.00001),shorter time to thoracic drainage tube removal(MD=-3.17,95%CI=-4.92~-1.41,P=0.0004),shorter hospital stay(MD=-3.45,95%CI=-4.39~-2.52,P<0.00001),and lower hospitalization costs(MD=-0.73,95%CI=-1.01~-0.44,P<0.00001),lower overall postoperative complication rate(OR=0.42,95%CI=0.27~0.65,P=0.0001).Conclusions:The application of ERAS in the perioperative period of TLE is safe and effective,and can promote rapid patient recovery.
作者
杨柳
张修华
邢加强
YANG Liu;ZHANG Xiuhua;XING Jiaqiang(Special Inspection Department,Linyi Cancer Hospital,Linyi 276000,China;Department of Thoracic Surgery,Linyi Cancer Hospital)
出处
《腹腔镜外科杂志》
2025年第1期61-69,共9页
Journal of Laparoscopic Surgery
关键词
食管肿瘤
食管癌根治术
胸腔镜检查
腹腔镜检查
术后加速康复
META分析
Esophageal neoplasms
Radical resection of esophageal carcinoma
Thoracoscopy
Laparoscopy
Enhanced recovery after surgery
Meta-analysis
