Application effect of fast track surgery for patients with esophageal cancer: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIU Jingjing ¹ , LU Jiaju ¹ , SHI Jiang ¹ , LIN Qingling ² , GUO Hong ² , TIAN Jinhui ³ ,  LIU Jian ² , YANG Kehu ³

1. The First Clinical Medical College of Lanzhou University, Lanzhou, 730000, P.R.China;
2. Department of ICU, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;
3. Evidence-based Medicine Center, Lanzhou University, Lanzhou, 730000, P.R.China;

Corresponding?author：

LIU Jian, Email: medecinliu@sina.com

Keywords：

Esophageal cancer; fast track surgery; perioperative period; systematic review

DOI：

10.7507/1007-4848.201707005

Video：

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Objective To evaluate the effect of fast track surgery (FTS) after esophageal cancer surgery. Methods The randomized controlled trial (RCT) and observational studies about FTS for esophageal cancer in PubMed、EMbase、The Cochrane Library、Web of Science、CBM、CNKI and WanFang databases were searched up to May 2017. Then the studies were screened according to the inclusion and exclusion criteria by two researchers. Data were analyzed by Stata12.0 software. Results Totally 13 RCTs and 5 observational studies with 2 447 patients were eligible for analysis. Compared with the control group, incidence of postoperative complications (OR=0.53, 95%CI 0.40 to 0.71, P<0.05) significantly reduced in the FTS group, but there was no significant difference between the two groups in readmission rate (OR=1.21, 95%CI 0.83 to 1.76, P=0.313) and 30 d mortality rate (OR=0.72, 95%CI 0.43 to 1.20, P=0.207). Conclusion FTS can safely and effectively accelerate the recovery of patients with esophageal cancer and it owns important clinical values.

Citation： LIU Jingjing, LU Jiaju, SHI Jiang, LIN Qingling, GUO Hong, TIAN Jinhui, LIU Jian, YANG Kehu. Application effect of fast track surgery for patients with esophageal cancer: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(7): 596-603. doi: 10.7507/1007-4848.201707005 Copy

1.	Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
2.	Gustafsson UO, Scott MJ, Schwenk W, et al. Enhanced Recovery After Surgery (ERAS) Society. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
3.	Nygren J, Thacker J, Carli F, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 801-816.
4.	Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 817-830.
5.	China Enhanced Recovery After Surgery Group of Chinese Society for Parenteral and Enteral Nutrition. Chinese consensus of enhanced recovery after surgery for colorectal surgery (2015). Zhonghua Wei Chang Wai Ke Za Zhi, 2015, 18(8): 785-787.
6.	Zhao JH, Sun JX, Huang XZ, et al. Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery. Int J Colorectal Dis, 2016, 31(3): 613-622.
7.	馬永恒, 王滿才, 高天明. 快速康復外科應用于食管癌的安全性和可行性的 Meta 分析及系統評價. 衛生職業教育, 2013, 31(3): 146-151.
8.	Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
9.	周洪偉, 范濤, 胡浩, 等. 快速康復外科在食管癌外科治療中的應用價值. 臨床外科雜志, 2014, 22(9): 703-704.
10.	趙桂彬, 曹守強, 張凱,等. 快速康復外科對食管癌手術患者胰島素抵抗指標的影響. 中華臨床營養雜志, 2012, 20(2): 78-83.
11.	陳雷. 圍手術期護理干預對食管癌手術預后的影響. 當代醫學, 2016, 22(16): 85-86.
12.	陳正平, 張紹嵐, 楊留才. 快速康復外科在食管癌外科手術中的應用. 科技通報, 2012, 28(8): 22-25.
13.	Sato H, Tsubosa Y. pp058-mon An enhanced recovery after surgery program in patients who have undergone thoracic esophageal cancer surgery reduces infectious complications. Clin Nutr, 2012, 7(1): 160-161.
14.	Wang JY, Hong X, Chen GH, et al. Clinical application of the fast track surgery model based on preoperative nutritional risk screening in patients with esophageal cancer. Asia Pac J Clin Nutr, 2015, 24(2): 206-211.
15.	錢軍. 應用快速康復外科治療食管癌患者的安全性及有效性分析. 實用臨床醫藥雜志, 2014, 18(23): 86-87.
16.	Tang J, Humes DJ, Gemmil E, et al. Reduction in length of stay for patients undergoing oesophageal and gastric resections with implementation of enhanced recovery packages. Ann R Coll Surg Engl, 2013, 95(5): 323-328.
17.	劉瑞. 食管癌圍手術期應用快速康復外科護理的效果觀察. 臨床醫藥文獻電子雜志, 2016, 3(52): 10382.
18.	林小芳, 黃先玲, 鐘番番, 等. 快速康復外科理念在食管癌患者圍術期中的應用. 齊魯護理雜志, 2014, 20(10): 43-44.
19.	Shewale JB, Correa AM, Baker CM, et al. Impact of a fast-track esophagectomy protocol on esophageal cancer patient outcomes and hospital charges. Ann Surg, 2015, 261(6): 1114-1123.
20.	李熠, 羅萍, 李哲, 等. 快速康復外科護理在食管癌患者圍手術期中應用效果. 國際醫藥衛生導報, 2015, 21(17): 2641-2643.
21.	公丕欣, 李春華, 陰其玲, 等. 加速康復外科在食管癌圍手術期中的護理應用. 泰山醫學院學報, 2016, 37(2): 155-157.
22.	Karran A, Wheat J, Chan D, et al. Propensity score analysis of an enhanced recovery programme in upper gastrointestinal cancer surgery. World J Surg, 2016, 40(7): 1645-1654.
23.	楊秀梅, 梁東云, 普春梅. 快速康復外科理念在食管癌圍手術期護理中的應用. 當代護士, 2015, 13(6): 56-57.
24.	馮桂榮, 李麗華. 快速康復外科理念在食管癌患者圍術期護理中的應用. 護理實踐與研究, 2013, 10(15): 44-45.
25.	丁瑋. 快速康復理念在胸腹腔鏡聯合食管癌根治術圍手術期護理中的應用. 醫藥與保健, 2014, 22(10): 124-125.
26.	Cao S, Zhao G, Cui J, et al. Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer, 2013, 21(3): 707-714.

1. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg, 2002, 183(6): 630-641.
2. Gustafsson UO, Scott MJ, Schwenk W, et al. Enhanced Recovery After Surgery (ERAS) Society. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 783-800.
3. Nygren J, Thacker J, Carli F, et al. Guidelines for perioperative care in elective rectal/pelvic surgery: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 801-816.
4. Lassen K, Coolsen MM, Slim K, et al. Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery (ERAS?) Society recommendations. Clin Nutr, 2012, 31(6): 817-830.
5. China Enhanced Recovery After Surgery Group of Chinese Society for Parenteral and Enteral Nutrition. Chinese consensus of enhanced recovery after surgery for colorectal surgery (2015). Zhonghua Wei Chang Wai Ke Za Zhi, 2015, 18(8): 785-787.
6. Zhao JH, Sun JX, Huang XZ, et al. Meta-analysis of the laparoscopic versus open colorectal surgery within fast track surgery. Int J Colorectal Dis, 2016, 31(3): 613-622.
7. 馬永恒, 王滿才, 高天明. 快速康復外科應用于食管癌的安全性和可行性的 Meta 分析及系統評價. 衛生職業教育, 2013, 31(3): 146-151.
8. Higgins JPT, Altman DG, Sterne JAC. Chapter 8: Assessing risk of bias in included studies. In: Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
9. 周洪偉, 范濤, 胡浩, 等. 快速康復外科在食管癌外科治療中的應用價值. 臨床外科雜志, 2014, 22(9): 703-704.
10. 趙桂彬, 曹守強, 張凱,等. 快速康復外科對食管癌手術患者胰島素抵抗指標的影響. 中華臨床營養雜志, 2012, 20(2): 78-83.
11. 陳雷. 圍手術期護理干預對食管癌手術預后的影響. 當代醫學, 2016, 22(16): 85-86.
12. 陳正平, 張紹嵐, 楊留才. 快速康復外科在食管癌外科手術中的應用. 科技通報, 2012, 28(8): 22-25.
13. Sato H, Tsubosa Y. pp058-mon An enhanced recovery after surgery program in patients who have undergone thoracic esophageal cancer surgery reduces infectious complications. Clin Nutr, 2012, 7(1): 160-161.
14. Wang JY, Hong X, Chen GH, et al. Clinical application of the fast track surgery model based on preoperative nutritional risk screening in patients with esophageal cancer. Asia Pac J Clin Nutr, 2015, 24(2): 206-211.
15. 錢軍. 應用快速康復外科治療食管癌患者的安全性及有效性分析. 實用臨床醫藥雜志, 2014, 18(23): 86-87.
16. Tang J, Humes DJ, Gemmil E, et al. Reduction in length of stay for patients undergoing oesophageal and gastric resections with implementation of enhanced recovery packages. Ann R Coll Surg Engl, 2013, 95(5): 323-328.
17. 劉瑞. 食管癌圍手術期應用快速康復外科護理的效果觀察. 臨床醫藥文獻電子雜志, 2016, 3(52): 10382.
18. 林小芳, 黃先玲, 鐘番番, 等. 快速康復外科理念在食管癌患者圍術期中的應用. 齊魯護理雜志, 2014, 20(10): 43-44.
19. Shewale JB, Correa AM, Baker CM, et al. Impact of a fast-track esophagectomy protocol on esophageal cancer patient outcomes and hospital charges. Ann Surg, 2015, 261(6): 1114-1123.
20. 李熠, 羅萍, 李哲, 等. 快速康復外科護理在食管癌患者圍手術期中應用效果. 國際醫藥衛生導報, 2015, 21(17): 2641-2643.
21. 公丕欣, 李春華, 陰其玲, 等. 加速康復外科在食管癌圍手術期中的護理應用. 泰山醫學院學報, 2016, 37(2): 155-157.
22. Karran A, Wheat J, Chan D, et al. Propensity score analysis of an enhanced recovery programme in upper gastrointestinal cancer surgery. World J Surg, 2016, 40(7): 1645-1654.
23. 楊秀梅, 梁東云, 普春梅. 快速康復外科理念在食管癌圍手術期護理中的應用. 當代護士, 2015, 13(6): 56-57.
24. 馮桂榮, 李麗華. 快速康復外科理念在食管癌患者圍術期護理中的應用. 護理實踐與研究, 2013, 10(15): 44-45.
25. 丁瑋. 快速康復理念在胸腹腔鏡聯合食管癌根治術圍手術期護理中的應用. 醫藥與保健, 2014, 22(10): 124-125.
26. Cao S, Zhao G, Cui J, et al. Fast-track rehabilitation program and conventional care after esophagectomy: a retrospective controlled cohort study. Support Care Cancer, 2013, 21(3): 707-714.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Application effect of fast track surgery for patients with esophageal cancer: A systematic review and meta-analysis

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