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World Journal of Surgery
Published in: World Journal of Surgery 8/2017

01-08-2017 | Original Scientific Report

Enhanced Recovery After Surgery (ERAS®) in Individuals with Diabetes: A Systematic Review

Authors: Zaina Albalawi, Michael Laffin, Leah Gramlich, Peter Senior, Finlay A. McAlister

Published in: World Journal of Surgery | Issue 8/2017

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Abstract

Background

Prevalence of diabetes in surgical patients is 10–40%. It is well recognized that they have higher rates of complications, and longer stays in hospital compared to patients without diabetes. Enhanced recovery after surgery (ERAS) is an evidence-based multimodal surgical care pathway that improves postoperative complications and length of stay in patients without diabetes. This review evaluates the evidence on whether individuals with diabetes would benefit from ERAS implementation.

Methods

MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE searched with no language restrictions applied. Conference proceedings and bibliographies were reviewed. Experts in the field were contacted, and www.​clinicaltrials.​gov searched for ongoing trials.

Selection criteria

Randomized controlled trials (RCT) looking at individuals with diabetes undergoing surgery randomized to ERAS® or conventional care. Non-randomized controlled trials, controlled before–after studies, interrupted time series, and cohort studies with concurrent controls were also considered. Two authors independently screened studies.

Results

The electronic search yielded 437 references. After removing duplicates, 376 were screened for eligibility. Conference proceedings and bibliographies identified additional references. Searching www.​clinicaltrials.​gov yielded 59 references. Contacting experts in the field identified no further studies. Fourteen full articles were assessed and subsequently excluded for the following reasons: used an intervention other than ERAS®, did not include patients with diabetes, or used an uncontrolled observational design.

Conclusions

To date, the effects of ERAS® on patients with diabetes have not been rigorously evaluated. This review highlights the lack of evidence in this area and provides guidance on design for future studies.
Appendix
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Metadata
Title
Enhanced Recovery After Surgery (ERAS®) in Individuals with Diabetes: A Systematic Review
Authors
Zaina Albalawi
Michael Laffin
Leah Gramlich
Peter Senior
Finlay A. McAlister
Publication date
01-08-2017
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 8/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-3982-y

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