A systematic review and meta-analysis of enhanced recovery for open abdominal aortic aneurysm surgery

Docherty, Jack, Morgan-Bates, Kersten and Stather, Philip ORCID: https://orcid.org/0000-0002-3585-6728 (2022) A systematic review and meta-analysis of enhanced recovery for open abdominal aortic aneurysm surgery. Vascular and Endovascular Surgery, 56 (7). pp. 655-664. ISSN 1538-5744

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Abstract

Introduction: Open abdominal aortic aneurysm (AAA) surgery is associated with significant morbidity, mortality and high length of stay (LOS). Enhanced recovery is now commonplace and has been shown to decrease these in other non-vascular surgery settings. This systematic review and meta-analysis aimed to assess the benefits of enhanced recovery (ERAS) in aortic surgery. Method: Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to undertake a systematic review via Ovid MEDLINE and Embase on 10.07.2021. The search terms were “aortic aneurysm” and “fast track” or “enhanced recovery”. Data was obtained on major complications, 30-day mortality and LOS. Results: 107 papers were identified and 10 papers included for meta-analysis. Complication rates were significantly reduced with ERAS compared to non-ERAS protocols (ERAS n = 709, non-ERAS n = 930) (odds ratio.38,.22 to.65: P =.0005). LOS was also significantly reduced with an ERAS protocol (ERAS n = 708, non-ERAS n = 956) with a mean reduction of 3.18 days (−5.01 to −1.35 days) (P =.0007: I2 = 97%). There was no significant difference however in 30-day mortality (P =.92). Conclusion: This meta-analysis demonstrates significant benefits to an enhanced recovery programme in open AAA surgery. There is a need for a multi-centre randomized controlled trial to assess this further.

Item Type: Article
Additional Information: Publisher Copyright: © The Author(s) 2022.
Uncontrolled Keywords: abdominal aortic aneursym,enhanced recovery,length of stay,major complications,open vascular surgery,surgery,cardiology and cardiovascular medicine ,/dk/atira/pure/subjectarea/asjc/2700/2746
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 22 Jun 2023 09:30
Last Modified: 07 Aug 2023 11:31
URI: https://ueaeprints.uea.ac.uk/id/eprint/92471
DOI: 10.1177/15385744221098810

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