title: The enhanced recovery after surgery (ERAS) pathway for patients undergoing colorectal surgery: an update of meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  This study aimed to produce a comprehensive, up-to-date meta-analysis exploring the safety and efficacy of enhanced recovery programs after colorectal resection.
  
  
  METHODS
  Medline, Embase, and Cochrane database searches were performed for relevant studies published between January 1966 and April 2012. All randomized controlled trials on fast track (FT) colorectal surgery were reviewed systematically. The main end points were short-term morbidity, length of primary postoperative hospital stay, length of total postoperative stay, readmission rate, and mortality.
  
  
  RESULTS
  Seven randomized controlled trials with 852 patients were included. The total length of hospital stay [mean difference (95 % confidence interval), -1.88 (-2.91, -0.86), p = 0.0003] and total complication rates [relative risk (95 % confidence interval), 0.69 (0.51, 0.93), p = 0.01] were significantly reduced in the enhanced recovery group. There was no statistically significant difference in readmission (risk ratio (RR) 0.90; 95 % confidence interval (CI) 0.52 to 1.53, p = 0.69) and mortality rates (RR 1.02; 95 % CI 0.40 to 2.57, p = 0.97).
  
  
  CONCLUSIONS
  Results suggested that enhanced recovery after surgery pathways can be able to reduce the length of stay and complication rates after major colorectal surgery without compromising patient safety. Future studies have to define the active elements in order to improve future fast track protocols.
authors.affiliation: Department of General Surgery, Affiliated Hospital, Qingdao University Medical College, Jiangsu Road 16#, Qingdao, 266003, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Lv
authors.forename: Yong-Fang
authors.initials: YF
authors.lastname: Shao
authors.forename: Yan-bing
authors.initials: YB
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D003107:Colorectal Surgery / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D019091:Critical Pathways; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010359:Patient Readmission; D011183:Postoperative Complications / Q000209:etiology; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment