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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 1/2014

01-01-2014 | Original Article

Fast-track surgery in gastrectomy for gastric cancer: a systematic review and meta-analysis

Authors: Zhen Yu, Cheng-Le Zhuang, Xing-Zhao Ye, Chang-Jing Zhang, Qian-Tong Dong, Bi-Cheng Chen

Published in: Langenbeck's Archives of Surgery | Issue 1/2014

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Abstract

Purpose

Fast-track surgery aims to attenuate the surgical stress response, reduce complications, and shorten hospital stay. The goal of the present meta-analysis is to assess the safety and effectiveness of fast-track surgery in patients undergoing gastrectomy for gastric cancer compared with conventional perioperative care.

Methods

PubMed, Embase, the Cochrane Central Register of Controlled Trials, and reference lists of the identified studies were searched to identify randomized clinical trials that compared fast-track surgery with conventional perioperative care in patients undergoing gastrectomy for gastric cancer.

Results

Five studies with a total of 400 patients were included in the meta-analysis. Meta-analysis shows that postoperative hospital stay (weighted mean difference (WMD) −1.87 days, 95 % confidence interval (CI), −2.46 to −1.28 days, P < 0.00001), time to first passage of flatus (WMD −0.71 days, 95 % CI, −1.03 to −0.39 days, P < 0.0001), and hospital costs (WMD −505.87 dollars, 95 % CI, −649.91 to −361.84 dollars, P < 0.00001) were significantly reduced for fast-track surgery. No significant differences were found for readmission rates (relative risk (RR), 1.97 95 % CI, 0.37 to 10.64, P = 0.43) and total postoperative complications (RR, 0.99 95 % CI, 0.56 to 1.76, P = 0.97).

Conclusions

Fast-track surgery is safe and effective in gastrectomy for gastric cancer. Further randomized trials are needed to strengthen the conclusions.
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Metadata
Title
Fast-track surgery in gastrectomy for gastric cancer: a systematic review and meta-analysis
Authors
Zhen Yu
Cheng-Le Zhuang
Xing-Zhao Ye
Chang-Jing Zhang
Qian-Tong Dong
Bi-Cheng Chen
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 1/2014
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-013-1148-4

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