Application of enhanced recovery after surgery principles in the perioperative management of lung cancer: a systematic review and meta-analysis based on randomized controlled trials

doi:10.3760/cma.j.cn441417-20241113-09014

Abstract

Abstract:

Objective　This study aimed to systematically evaluate the impact of enhanced recovery after surgery (ERAS) principles on perioperative outcomes in patients undergoing lung cancer surgery. Methods　Randomized controlled trials on the application effect of ERAS concept in the perioperative period of lung cancer were retrieved from databases such as PubMed, EMBASE, Cochrane Library, CNKI, Wanfang, and VIP from the establishment of the databases to July 2024, and the references included in the studies were traced. Medical subject headings and keywords were used to search. Meta-analysis was performed using STATA 16.0 software, and publication bias was assessed by funnel plot and Egger test. Results Finally, 13 articles (1 719 patients) were included. The results of the meta-analysis showed that the incidence of postoperative complications in the ERAS group was lower than that in the control group (OR=0.33, 95%CI: 0.26-0.41, P<0.01); the postoperative pain score of the ERAS group was lower than that of the control group(WMD=-1.04, 95%CI: -1.46--0.61, P<0.01); the retention time of the drainage tube in the ERAS group was shorter than that in the control group(WMD=-2.40, 95%CI: -3.08--1.72, P<0.01); the hospitalization time of the ERAS group was shorter than that of the control group(WMD=-3.51, 95%CI: -4.33--2.68, P<0.01). Conclusion Implementing ERAS principles in the perioperative management of lung cancer patients significantly reduces postoperative complication rates and pain levels and shortens both chest tube duration and hospital stay.

摘要：

目的　系统评价加速康复外科（ERAS）理念在肺癌围手术期的应用效果。方法　系统检索PubMed、EMBASE、Cochrane Library、中国知网、万方和维普数据库中有关ERAS理念在肺癌围手术期应用效果的随机对照试验，并追溯纳入研究的参考文献。采用主题词结合自由词的方式进行检索。检索时限：建库至2024年7月。采用STATA 16.0软件进行meta分析，采用漏斗图和Egger检验评估发表偏倚。结果　共纳入15篇文献（1 719例患者）。meta分析结果显示：ERAS组术后并发症发生率低于对照组（OR=0.33，95%CI：0.26～0.41，P<0.01）；ERAS组术后疼痛评分低于对照组（WMD=-1.04，95%CI：-1.46～-0.61，P<0.01）；ERAS组引流管留置时间短于对照组（WMD=-2.40，95%CI：-3.08～-1.72，P<0.01）；ERAS组住院时间短于对照组（WMD=-3.51，95%CI：-4.33～-2.68，P<0.01）。结论　采用ERAS理念的围手术期管理可有效降低肺癌患者术后并发症发生率和术后疼痛评分，缩短引流管留置时间和住院时间。

Lyu Xiaodong, Gao Chengfei, Zhao Jinpeng.

Application of enhanced recovery after surgery principles in the perioperative management of lung cancer: a systematic review and meta-analysis based on randomized controlled trials [J]. International Medicine and Health Guidance News, 2025, 31(9): 1475-1481.

吕晓东高呈飞赵金鹏.

加速康复外科理念在肺癌围手术期的应用：一项基于随机对照试验的系统评价与meta分析 [J]. 国际医药卫生导报, 2025, 31(9): 1475-1481.

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