title: Enhanced Recovery after Surgery Programs for Liver Resection: a Meta-analysis.
abstract: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy.
  
  
  
  We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design. We assessed the methodological quality of the included studies and excluded studies of poor quality. We performed a meta-analysis using RevMan 5.3 software.
  
  
  
  In total, 19 original studies with 2575 patients, including four randomized controlled trials and 15 non-randomized controlled trials, were analyzed. The meta-analysis demonstrated that enhanced recovery after surgery programs could reduce morbidity, hospital stays and cost, blood loss, and time to bowel function recovery for both open and laparoscopic surgery without increasing mortality, readmission rate, or transfusion rate. Twelve items were essential for liver surgery.
  
  
  
  Enhanced recovery after surgery programs for hepatectomy are feasible and efficient. Further studies should optimize perioperative outcomes for liver surgery.
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China.
authors.forename: Guoqun
authors.initials: G
authors.lastname: Zheng
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China.
authors.forename: Wenlong
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China.
authors.forename: Fabiao
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China.
authors.forename: Shangdong
authors.initials: S
authors.lastname: Lv
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China.
authors.forename: Aidong
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China. fangzheping@yeah.net.
authors.forename: Zheping
authors.identifier: 0000-0002-9618-8102
authors.initials: Z
authors.lastname: Fang
mesh_terms: D001803:Blood Transfusion; D004434:Early Ambulation; D006498:Hepatectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D006801:Humans; D007902:Length of Stay; D011182:Postoperative Care / Q000379:methods*; D019106:Postoperative Hemorrhage / Q000209:etiology; D020127:Recovery of Function
keywords: Enhanced recovery after surgery; Hepatectomy; Liver resection; Liver surgery; Meta-analysis