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Colombian Journal of Anestesiology
Print version ISSN 0120-3347On-line version ISSN 2256-2087
Abstract
CHACON ACEVEDO, Kelly Rocío et al. Effectiveness and safety of the enhanced recovery program in colorectal surgery: overview of systematic reviews. Rev. colomb. anestesiol. [online]. 2021, vol.49, n.1, e400. Epub Jan 04, 2021. ISSN 0120-3347. https://doi.org/10.5554/22562087.e943.
Introduction
Multimodal enhanced recovery programs are a new paradigm in perioperative care.
Objective
To evaluate the certainty of evidence pertaining to the effectiveness and safety of the multimodal perioperative care program in elective colorectal surgery.
Data source: A search was conducted in the Medline, EMBASE, and Cochrane databases, up until February 2020.
Eligibility criteria
Systematic reviews that take into account the perioperative multimodal program in patients with an indication for colorectal surgery were included. The primary outcomes were morbidity and postoperative deaths. The secondary outcome was hospital length of stay.
Study quality and synthesis method
The reviews were evaluated with AMSTAR-2 and the certainty of the evidence with the GRADE methodology. The findings are presented with measures of frequency, risk estimators, or differences.
Results
Six systematic reviews of clinical trials with medium and high quality in AMSTAR-2 were included. Morbidity was reduced between 16 and 48%. Studies are inconclusive regarding postoperative mortality. Hospital length of stay was reduced by an average of 2.5 days (p <0.05). The certainty of the body of evidence is very low.
Limitations
The effect of the program, depending on the combination of elements, is not clear.
Conclusions and implications
Despite the proven evidence that the program is effective in reducing global postoperative morbidity and hospital stay, the body of evidence is of very low quality. Consequently, results may change with new evidence and further research is required.
Keywords : Colorectal surgery; perioperative care; enhanced recovery; systematic reviews; health technology assessment.