加速康复外科在结直肠癌合并糖尿病患者手术中应用的meta分析

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Abstract Objective To systematically evaluate the safety and effectiveness of enhanced recovery after surgery (ERAS) in colorectal cancer patients with diabetes mellitus. Methods Based on the key words of “colorectal cancer” “colorectal surgery” “diabetes” “enhanced recovery after surgery” and “fast track surgery”, PubMed, EMBASE, Cochrane Library, CNKI, VIP and Wanfang databases were searched for articles on the application of ERAS in the operation of colorectal cancer patients with diabetes from the establishment of the database to November 2020. Qualified articles were screened out according to the inclusion and exclusion criteria, the patients were divided into ERAS group (ERAS measure processing) and control group (conventional measures treatment). The time to first flatus, time to first defecation, length of hospital stay, hospital charge and incidence of complications were compared between the two groups. Revman 5.4 software was used for meta-analysis. Results A total of 725 patients were included, including 372 patients in the ERAS group and 353 patients in the control group. In ERAS group, the postoperative anal exhaust time (SMD = -2.20, 95%CI[-2.72，-1.69], P ＜ 0.000 01), the postoperative defecation time (MD = -1.51, 95%CI[-2.09, -0.93]，P ＜ 0.000 01), the length of hospital stay (MD = -3.18，95%CI[-4.36，-2.01]，P ＜ 0.000 01) were shorter than those in the control group, the hospitalization cost (SMD = -0.73，95%CI[-0.98, -0.48], P ＜ 0.000 01) was lower than that of the control group, and the incidence of complications (OR = 0.29, 95%CI[0.18, 0.49], P ＜ 0.000 01) was lower than that of the control group. Conclusion The application of ERAS in colorectal cancer patients with diabetes mellitus is safe and effective, which is conducive to the recovery of postoperative intestinal function, reducing length of stay, hospital charge and incidence of complications, but it still needs higher level evidence-based support.

Key words： Enhanced recovery after surgery Colorectal cancer Diabetes mellitus Meta-analysis

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	FENG Le1 QIN Yan1 FAN Xin2 CHEN Jixiang2

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FENG Le1 QIN Yan1 FAN Xin2 CHEN Jixiang2. Application of enhanced recovery after surgery programs in colorectal cancer patients with diabetes mellitus: a meta-analysis[J]. 中国医药导报, 2021, 18(13): 80-84,92.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2021/V18/I13/80

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