Enhanced Recovery After Surgery (ERAS) protocols following emergency intra-abdominal surgery: A systematic review and meta-analysis protocol

Objective The aim of this systematic review and meta-analysis is to evaluate whether the implementation of Enhanced Recovery After Surgery (ERAS) protocols for adult patients undergoing emergency intra-abdominal surgery decreases postoperative length of stay, postoperative morbidity, and mortality c...

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Bibliographic Details
Published in:PloS one 2023-09, Vol.18 (9), p.e0291140
Main Authors: McKechnie, Tyler, Parpia, Sameer, Bhandari, Mohit, Dionne, Joanna C, Eskicioglu, Cagla
Format: Article
Language:English
Subjects:
Abdomen
Abdominal surgery
Analysis
Canada
Clinical trials
Cohort analysis
Elective surgery
Evaluation
Gastrointestinal surgery
Health aspects
Infections
Intraabdominal surgery
Laparotomy
Length of stay
Medical research
Medicine and Health Sciences
Medicine, Experimental
Meta-analysis
Methods
Morbidity
Mortality
Patient outcomes
Patients
Perioperative care
Physical Sciences
Postoperative period
Recovery
Recovery (Medical)
Research and Analysis Methods
Study Protocol
Surgery
Systematic review
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Summary:Objective The aim of this systematic review and meta-analysis is to evaluate whether the implementation of Enhanced Recovery After Surgery (ERAS) protocols for adult patients undergoing emergency intra-abdominal surgery decreases postoperative length of stay, postoperative morbidity, and mortality compared to conventional perioperative care. Methods A systematic review and meta-analysis will be performed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). It has been registered on the International Prospective Register for Systematic Reviews (PROSPERO; CRD42023391709). A comprehensive, electronic search strategy will be used to identify studies published and indexed in MEDLINE, EMBASE, Web of Science, CENTRAL, and Pubmed databases since their inception. Trial registries and references of included studies and pertinent previous systematic reviews will also be searched. Studies will be included if they are randomized controlled trials or cohort studies evaluating adult patients undergoing emergency intra-abdominal surgery and comparing ERAS or modified ERAS protocols to conventional perioperative care and report one of the following outcomes: postoperative length of stay, overall 30-day morbidity, 30-day mortality, 30-day infectious morbidity, prolonged postoperative ileus, return of bowel function, and 30-day readmissions. A meta-analysis will be performed using a random effects model for all comparative data using Cochrane Review Manager 5.3 (London, United Kingdom). Discussion ERAS protocols have become standard of care for patients undergoing elective surgery. Their use in the setting of emergency surgery is far less common. The aim of this systematic review and meta-analysis is to assess whether there are benefits in patient important outcomes with the implementation of ERAS protocols for patients undergoing emergency intra-abdominal surgery. Ultimately, we hope to promote their use and further large randomized controlled trials evaluating emergency surgery ERAS programs. Prospero registration number CRD42023391709.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0291140