scholarly journals Timing of cholecystectomy after percutaneous cholecystectomy for acute cholecystitis- A systematic review and meta-analysis

2021 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Biliary Tract ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Mean Difference ◽  
Complication Rates ◽  
Percutaneous Cholecystostomy ◽  
Timing Of Cholecystectomy

Introduction: There is a controversy about the optimum timing of cholecystectomy after percutaneous cholecystostomy. This systematic review and meta-analysis aimed to evaluate outcomes of early versus late cholecystectomy after percutaneous cholecystectomy. Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2 statistics. The random-effects model was used. We evaluated cholecystectomy performed at different periods after percutaneous cholecystostomy within 72 hours or later, within or after one week or percutaneous cholecystostomy, within 10 days or after 10 days, less than 2 weeks or more than 2 weeks, less than 4 weeks or more than 4 weeks, less than 8 weeks or more than 8 weeks as per literature. Results: Six studies including 18640 patients were included in the final analysis. There was no difference in overall complications within or after 72 hours cholecystectomy group, but mortality and biliary complications were significantly high in the less than 72 hours group (p=0.05 and 0.0002 respectively). There was no difference in mortality, overall complication, biliary tract complications in less than 1 week versus more than 1 week and less than 10 days versus more than 10 days group. Overall complications were significantly less in the less than 2 weeks group compared to the more than 2 weeks group. There was no difference in mortality and biliary tract complications between less than 2 weeks and more than 2 weeks group. Overall complication rate (risk ratio 0.67, p <0.0001), postoperative mortality (risk ratio 0.46, p=0.003), bile duct injury (risk ratio 0.62, p=0.01) was significantly less in earlier than 4-week group. Hospital stay was not significantly different between less than 4 weeks versus more than 4 weeks group. (Mean difference= -2.74, p=0.12). Ove all complication rates were significantly more in less than 8 weeks group. (Risk ratio 1.07, p=0.01). Hospital stay was significantly less in less than 8 weeks group. (Mean difference 0.87, p=0.01). Conclusion: Early cholecystectomy preferably within 4 weeks after percutaneous cholecystostomy is preferable over late cholecystectomy.

scholarly journals Timing of cholecystectomy after percutaneous cholecystostomy for acute cholecystitis- A systematic review and meta-analysis

2021 ◽  
Author(s):  
BHAVIN VASAVADA ◽  
Hardik Patel
Keyword(s):  
Biliary Tract ◽  
Risk Ratio ◽  
Injury Risk ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Final Analysis ◽  
Complication Rates ◽  
Percutaneous Cholecystostomy ◽  
Prisma Statement ◽  
Timing Of Cholecystectomy

Abstract Introduction: This meta-analysis aimed to evaluate outcomes of early versus late cholecystectomy after percutaneous cholecystostomy.Methods:The study was conducted according to the PRISMA statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2 statistics. The random-effects model was used.Results: Six studies including 18640 patients were included in the final analysis. There was no difference in overall complications within or after 72 hours cholecystectomy group, but mortality and biliary complications were significantly high in the less than 72 hours group (p=0.05 and 0.0002 respectively). There was no difference in mortality, overall complication, biliary tract complications in less than 1 week versus more than 1 week and less than 10 days versus more than 10 days group. Overall complications were significantly less in the less than 2 weeks group compared to the more than 2 weeks group. There was no difference in mortality and biliary tract complications between less than 2 weeks and more than 2 weeks group. Overall complication rate (risk ratio 0.67, p <0.0001), postoperative mortality (risk ratio 0.46, p=0.003), bile duct injury (risk ratio 0.62, p=0.01) was significantly less in earlier than 4-week group. Hospital stay was not significantly different between less than 4 weeks versus more than 4 weeks group. (Mean difference= -2.74, p=0.12). Ove all complication rates were significantly more in less than 8 weeks group. (Risk ratio 1.07, p=0.01).Conclusion:Early cholecystectomy preferably within 4 weeks after percutaneous cholecystostomy is preferable.

scholarly journals Non-intubated thoracoscopic lobectomies for lung cancer: an exploratory systematic review and meta-analysis

2020 ◽  
Vol 31 (4) ◽  
pp. 499-506 ◽  
Author(s):  
Elena Prisciandaro ◽  
Luca Bertolaccini ◽  
Giulia Sedda ◽  
Lorenzo Spaggiari
Keyword(s):  
Lung Cancer ◽  
Systematic Review ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Complication Rates ◽  
Thoracoscopic Lobectomy ◽  
Retrospective Cohort Studies ◽  
The Individual

Abstract Our goal was to assess the safety, feasibility and oncological outcomes of non-intubated thoracoscopic lobectomies for non-small-cell lung cancer (NSCLC). A comprehensive search was performed in EMBASE (via Ovid), MEDLINE (via PubMed) and Cochrane CENTRAL from January 2004 to March 2020. Studies comparing non-intubated anaesthesia with intubated anaesthesia for thoracoscopic lobectomy for NSCLC were included. An exploratory systematic review and a meta-analysis were performed by combining the reported outcomes of the individual studies using a random effects model. For dichotomous outcomes, risk ratios were calculated and for continuous outcomes, the mean difference was used. Three retrospective cohort studies were included, with a total of 204 patients. The comparison between non-intubated and intubated patients undergoing thoracoscopic lobectomy showed no statistically significant differences in postoperative complication rates [risk ratio 0.65, 95% confidence interval (CI) 0.36–1.16; P = 0.30; I2 = 17%], operating times (mean difference −12.40, 95% CI −28.57 to 3.77; P = 0.15; I2 = 48%), length of hospital stay (mean difference −1.13, 95% CI −2.32 to 0.05; P = 0.90; I2 = 0%) and number of dissected lymph nodes (risk ratio 0.92, 95% CI 0.78–1.25; P = 0.46; I2 = 0%). Despite the limitation of only 3 papers included, awake and intubated thoracoscopic lobectomies for resectable NSCLC seem to have comparable perioperative and postoperative outcomes. Nevertheless, the oncological implications of the non-intubated approach should be considered. The long-term benefits for patients with lung cancer need to be carefully assessed.

scholarly journals Minimally invasive versus conventional surgery of the ascending aorta and root: a systematic review and meta-analysis

2019 ◽  
Vol 57 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Tom A Rayner ◽  
Sean Harrison ◽  
Paul Rival ◽  
Dominic E Mahoney ◽  
Massimo Caputo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Impairment ◽  
Minimally Invasive ◽  
Risk Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Ascending Aorta ◽  
Mean Difference ◽  
Standardized Mean Difference

Summary Limited uptake of minimally invasive surgery (MIS) of the aorta hinders assessment of its efficacy compared to median sternotomy (MS). The objective of this systematic review is to compare operative and perioperative outcomes for MIS versus MS. Online databases Medline, EMBASE, Cochrane Library and Web of Science were searched from inception until July 2018. Both randomized and observational studies of patients undergoing aortic root, ascending aorta or aortic arch surgery by MIS versus MS were eligible for inclusion. Primary outcomes were 30-day mortality, reoperation for bleeding, perioperative renal impairment and neurological events. Intraoperative and postoperative timing measures were also evaluated. Thirteen observational studies were included comparing 1101 MIS and 1405 MS patients. The overall quality of evidence was very low for all outcomes. Mortality and the incidence of stroke were similar between the 2 cohorts. Meta-analysis demonstrated increased length of cardiopulmonary bypass (CPB) time for patients undergoing MS [standardized mean difference 0.36, 95% confidence interval (CI) 0.15–0.58; P = 0.001]. Patients receiving MS spent more time in hospital (standardized mean difference 0.30, 95% CI 0.17–0.43; P &lt; 0.001) and intensive care (standardized mean difference 0.17, 95% CI 0.06–0.27; P &lt; 0.001). Reoperation for bleeding (risk ratio 1.51, 95% CI 1.06–2.17; P = 0.024) and renal impairment (risk ratio 1.97, 95% CI 1.12–3.46; P = 0.019) were also greater for MS patients. There was substantial heterogeneity in meta-analyses for CPB and aortic cross-clamp timing outcomes. MIS may be associated with improved early clinical outcomes compared to MS, but the quality of the evidence is very low. Randomized evidence is needed to confirm these findings.

scholarly journals Ketamine for the multivariate effect of PTSD: Systematic review and meta-analysis

2021 ◽  
Author(s):  
Rui Du ◽  
Kun Niu ◽  
Guofang Lu ◽  
Yulong Shang
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Group Analysis ◽  
Mean Difference ◽  
Bibliographic Databases ◽  
Post Traumatic Stress ◽  
Chronic Ptsd ◽  
Inverse Variance ◽  
Mental Illness Treatment

The aim of this systematic review and meta-analysis was to examine the efficacy, anti-effect of ketamine (intervention) for post-traumatic stress disorder (PTSD) patients during analgesia proceeding and mental illness treatment methods, in comparison with control (midazolam, opioid, saline or placebo). The bibliographic databases Cochrane, Embase, Pubmed and Web of Science were searched from inception to 23 May 2021 for randomized controlled trials, case-control and cohort studies included. For continuous and dichotomous outcomes, respectively, we calculated the mean difference using the inverse-variance method and the risk ratio with the Mantel-Haenszel method. In all, ten trials with 705 patients were included. Confirmed by meta-analysis, ketamine didn't increase the prevalence of PTSD by a risk ratio (95 % CI) of 0.86 (0.61 to 1.20), p = 0.38 in 3 trials with 503 patients. Evidence of a difference was found in the PTSD-scales taken between ketamine and control during short durations (months), with a mean difference (95 % CI) of 2.45 (1.33 to 3.58), p < 0.001 in three trials with 65 patients. Another evidence is shown in chronic PTSD (years), with a mean difference (95 % CI) of -3.66 (-7.05 to -0.27), p = 0.03 in three trials with 91 patients. Sub-group analysis underlined the increased benefit of ketamine administration for those in whom the procedure was more than one week in the chronic PTSD group. The adoption of ketamine for the short duration of PTSD is in avoidance, but for chronic PTSD is recommended and, in the opinion of the authors, should be considered as a new therapy in view of its potential to ameliorate arousal, avoidance and dissociative symptoms, neuroticism after trauma needing more animal research and clinical trials.

scholarly journals Efficacy of probiotics in the prevention of VAP in critically ill ICU patients: an updated systematic review and meta-analysis of randomized control trials

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Priyam Batra ◽  
Kapil Dev Soni ◽  
Purva Mathur
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Critically Ill ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Icu Stay ◽  
Length Of Icu Stay

Abstract Introduction Ventilator-associated pneumonia (VAP) is reported as the second most common nosocomial infection among critically ill patients with the incidence ranging from 2 to 16 episodes per 1000 ventilator days. The use of probiotics has been shown to have a promising effect in many RCTs. Our systematic review and meta-analysis were thus planned to determine the effect of probiotic use in critically ill ventilated adult patients on the incidence of VAP, length of hospital stay, length of ICU stay, duration of mechanical ventilation, the incidence of diarrhea, and the incidence of oropharyngeal colonization and in-hospital mortality. Methodology Systematic search of various databases (such as Embase, Cochrane, and Pubmed), published journals, clinical trials, and abstracts of the various major conferences were made to obtain the RCTs which compare probiotics with placebo for VAP prevention. The results were expressed as risk ratios or mean differences. Data synthesis was done using statistical software - Review Manager (RevMan) Version 5.4 (The Cochrane Collaboration, 2020). Results Nine studies met our inclusion criterion and were included in the meta-analysis. The incidence of VAP (risk ratio: 0.70, CI 0.56, 0.88; P = 0.002; I2 = 37%), duration of mechanical ventilation (mean difference −3.75, CI −6.93, −0.58; P 0.02; I2 = 96%), length of ICU stay (mean difference −4.20, CI −6.73, −1.66; P = 0.001; I2 = 84%) and in-hospital mortality (OR 0.73, CI 0.54, 0.98; P = 0.04; I2 = 0%) in the probiotic group was significantly lower than that in the control group. Probiotic administration was not associated with a statistically significant reduction in length of hospital stay (MD −1.94, CI −7.17, 3.28; P = 0.47; I2 = 88%), incidence of oro-pharyngeal colonization (OR 0.59, CI 0.33, 1.04; P = 0.07; I2 = 69%), and incidence of diarrhea (OR 0.59, CI 0.34, 1.03; P = 0.06; I2 = 38%). Discussion Our meta-analysis shows that probiotic administration has a promising role in lowering the incidence of VAP, the duration of mechanical ventilation, length of ICU stay, and in-hospital mortality.

Laryngeal Mask Airway for Surfactant Administration Versus Standard Treatment Methods in Preterm Neonates with Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Roqaia Ayesh Al Ali ◽  
Bishal Gautam ◽  
Michael R. Miller ◽  
Sherry Coulson ◽  
Doris Yuen
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Laryngeal Mask Airway ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Risk Ratio ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Mean Difference ◽  
Laryngeal Mask

Objective Laryngeal mask airway (LMA) has emerged as an alternative surfactant delivery method. The effectiveness of this method for the delivery of surfactant is uncertain. A meta-analysis of randomized control trials (RCTs) comparing LMA with standard methods of surfactant delivery for the outcomes of surfactant dose repetition, oxygen requirement, mechanical ventilation, intubation, mortality, bronchopulmonary dysplasia (BPD), and pneumothorax. Study Design Systematic review and meta-analysis of RCTs. Homogeneity between studies was analyzed by using I2 statistics. Risk ratio or mean difference of outcomes was assessed from random effects models. Subgroup analyses were conducted when necessary. Data sources are as follows: Ovid Medline, Embase, and the Cochrane Central Register of Controlled trials from inception till December 2018, bibliographies of identified reviews and trial registries for ongoing studies. RCTs comparing short-term respiratory outcomes in neonates with respiratory distress syndrome who were administered surfactant through an LMA versus standard method of care. Results Six RCTs were identified, enrolling a total of 357 infants. Administering surfactant via LMA was associated with decreased FiO2 requirement (mean difference = 1.82 (95% confidence interval [CI]: −6.01 to 9.66), decreased intubation (risk ratio [RR] = 0.17; 95% CI: 0.05–0.57), and decreased mechanical ventilation (RR = 0.44; 95% CI: 0.31–0.61). There were no significant differences between groups for death, BPD, or pneumothorax. Conclusion LMA might be an effective alternative method of surfactant delivery; however, further high-quality RCTs with larger sample size and including extreme preterm infants are needed to establish LMA as an alternative technique for surfactant delivery. Key Points

Prognostic Significance of Hyponatremia in Acute Stroke: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 49 (5) ◽  
pp. 531-539
Author(s):  
Shogo Shima ◽  
Yasunari Niimi ◽  
Yosuke Moteki ◽  
Osamu Takahashi ◽  
Shinsuke Sato ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Mean Difference ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Stroke Patients

<b><i>Objective:</i></b> Hyponatremia is a common electrolyte disorder in patients with stroke, which leads to various fatal complications. We performed a systematic review and meta-analysis to investigate the outcomes of acute stroke patients with hyponatremia. <b><i>Methods:</i></b> We searched MEDLINE, EMBASE, and the Cochrane Library databases for relevant literature in English published up to March 2020. Two review authors independently screened and selected the studies by assessing the eligibility and validity based on the inclusion criteria. Mortality at 90 days was set as the primary end point, and in-hospital mortality and length of hospital stay were set as the secondary end points. We conducted the data synthesis and analyzed the outcomes by calculating the odds ratio (OR) and mean difference. <b><i>Results:</i></b> Of 835 studies, 15 studies met the inclusion criteria (<i>n</i> = 10,745). The prevalence rate of stroke patients with hyponatremia was 7.0–59.2%. They had significantly higher 90-day mortality (OR, 1.73; 95% confidence interval (CI), 1.24–2.42) and longer length of hospital stay (mean difference, 10.68 days; 95% CI, 7.14–14.22) than patients without hyponatremia. Patients with hyponatremia had a higher tendency of in-hospital mortality than those without hyponatremia (OR, 1.61; 95% CI, 0.97–2.69). <b><i>Conclusions:</i></b> The development of hyponatremia in the clinical course of stroke is associated with higher short-term mortality and a longer hospital stay. Although the causal relationship is unclear, hyponatremia could be a significant predictor of poor outcomes after stroke.

Transcatheter versus surgical closure of atrial septal defects: a systematic review and meta-analysis of clinical outcomes

2021 ◽  
pp. 1-9
Author(s):  
Aimee-Louise Chambault ◽  
Kathryn Olsen ◽  
Louise J. Brown ◽  
Sophie L. Mellor ◽  
Nilofer Sorathia ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hospital Stay ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Mean Difference ◽  
Complication Rates ◽  
Surgical Closure ◽  
Septal Defects ◽  
Atrial Septal Defects ◽  
Significant Difference

Abstract Background: Atrial septal defects are a common form of CHD and dependent on the size and nature of atrial septal defects, closure may be warranted. The paper aims to compare outcomes of transcatheter versus surgical repair of atrial septal defects. Methods: A comprehensive electronic literature search was conducted. Primary studies were included if they compared both closure techniques. Primary outcomes included procedural success, mortality, and reintervention rate. Secondary outcomes included residual defect and mean hospital stay. Results: A total of 33 studies were included in meta-analysis. Mean total hospital stay was significantly shorter in the transcatheter cohort across both the adult (95% confidence interval, mean difference −4.05 (−4.78, −3.32) p < 0.00001) and paediatric populations (95% confidence interval, mean difference −4.78 (−5.97, −3.60) p < 0.00001). There were significantly fewer complications in the transcatheter group across both the adult (odds ratio 0.45, 95% confidence interval, [0.28, 0.72], p < 0.00001) and paediatric cohorts (odds ratio 0.26, 95% confidence interval, [0.14, 0.49], p < 0.00001). No significant difference in overall mortality was found between transcatheter versus surgical closure across the two groups, adult (odds ratio 0.76, 95% confidence interval, [0.40, 1.45], p = 0.41), paediatrics (odds ratio 0.62, 95% confidence interval, [0.21, 1.83], p = 0.39). Conclusion: Both transcatheter and surgical approaches are safe and effective techniques for atrial septal defect closure. Our study has demonstrated the benefits of transcatheter closure in terms of lower complication rates and mean hospital stay. However, surgery still has a place for more complex closure and, as we have demonstrated, shows no difference in mortality.

scholarly journals A systematic review and meta-analysis on chloroquine and hydroxychloroquine as monotherapy or combined with azithromycin in COVID-19 treatment

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ramy Mohamed Ghazy ◽  
Abdallah Almaghraby ◽  
Ramy Shaaban ◽  
Ahmed Kamal ◽  
Hatem Beshir ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Mean Difference ◽  
In Vivo Studies ◽  
Published Data ◽  
Duration Of Hospital Stay ◽  
Standard Mean Difference ◽  
Clinical Worsening

AbstractMany recent studies have investigated the role of either Chloroquine (CQ) or Hydroxychloroquine (HCQ) alone or in combination with azithromycin (AZM) in the management of the emerging coronavirus. This systematic review and meta-analysis of either published or preprint observational studies or randomized control trials (RCT) aimed to assess mortality rate, duration of hospital stay, need for mechanical ventilation (MV), virologic cure rate (VQR), time to a negative viral polymerase chain reaction (PCR), radiological progression, experiencing drug side effects, and clinical worsening. A search of the online database through June 2020 was performed and examined the reference lists of pertinent articles for in-vivo studies only. Pooled relative risks (RRs), standard mean differences of 95% confidence intervals (CIs) were calculated with the random-effects model. Mortality was not different between the standard care (SC) and HCQ groups (RR = 0.99, 95% CI 0.61–1.59, I2 = 82%), meta-regression analysis proved that mortality was significantly different across the studies from different countries. However, mortality among the HCQ + AZM was significantly higher than among the SC (RR = 1.8, 95% CI 1.19–2.27, I2 = 70%). The duration of hospital stay in days was shorter in the SC in comparison with the HCQ group (standard mean difference = 0.57, 95% CI 0.20–0.94, I2 = 92%), or the HCQ + AZM (standard mean difference = 0.77, 95% CI 0.46–1.08, I2 = 81). Overall VQR, and that at days 4, 10, and 14 among patients exposed to HCQ did not differ significantly from the SC [(RR = 0.92, 95% CI 0.69–1.23, I2 = 67%), (RR = 1.11, 95% CI 0.26–4.69, I2 = 85%), (RR = 1.21, 95% CI 0.70–2.01, I2 = 95%), and (RR = 0.98, 95% CI 0.76–1.27, I2 = 85% )] respectively. Exposure to HCQ + AZM did not improve the VQR as well (RR = 3.23, 95% CI 0.70–14.97, I2 = 58%). The need for MV was not significantly different between the SC and HCQ (RR = 1.5, 95% CI 0.78–2.89, I2 = 81%), or HCQ + AZM (RR = 1.27, 95% CI 0.7–2.13, I2 = 88%). Side effects were more reported in the HCQ group than in the SC (RR = 3.14, 95% CI 1.58–6.24, I2 = 0). Radiological improvement and clinical worsening were not statistically different between HCQ and SC [(RR = 1.11, 95% CI 0.74–1.65, I2 = 45%) and (RR = 1.28, 95% CI 0.33–4.99), I2 = 54%] respectively. Despite the scarcity of published data of good quality, the effectiveness and safety of either HCQ alone or in combination with AZM in treating COVID-19 cannot be assured. Future high-quality RCTs need to be carried out.PROSPERO registration: CRD42020192084.

scholarly journals Effectiveness of Enhanced Recovery After Surgery (ERAS) for patients undergoing hysterectomy: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Chengyi Ho ◽  
Hui Xian Oh ◽  
Zi An Shian Seah ◽  
Jiemin Zhu ◽  
Hong-Gu HE
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Data Extraction ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Length Of Hospital Stay ◽  
Laparoscopic Hysterectomy ◽  
Complication Rates

Background: There is a lack of systematic review exploring the effectiveness of Enhanced Recovery After Surgery (ERAS) in hysterectomy in promoting better recovery. Objectives: To synthesize the best available evidence of the effectiveness of ERAS intervention in promoting better recovery of shortened length of hospital stay (primary outcome), lower readmission, and complication rates (secondary outcomes) among patients undergoing hysterectomy due to benign conditions as compared to conventional perioperative care. Search Strategy: Seven electronic databases were searched from the date of inception to December 2020. Selection Criteria: Randomized controlled trials, cohort studies, or quasi-experimental studies published in English examining the effects of ERAS for women diagnosed with benign gynecologic diseases and underwent either abdominal or laparoscopic hysterectomy were included. Data Collection and Analysis: Two reviewers independently conducted database search, data extraction, and methodological quality assessment. Meta-analyses were performed for all outcomes. The overall quality of evidence was assessed using GRADE. Main Results: Nine studies were included in this review. Meta-analysis showed a statistically significant reduction in length of hospital stay (SMD = -0.76, 95% CI [-1.06, -0.46], Z = 4.72, p < .00001), readmission rate (RR = 0.65, 95% CI [0.44-0.96]; Z = 2.16, p = .03) and complication rate (RR = 0.61, 95% CI [0.48-0.77]; Z = 4.17, p < .0001), with high certainty of evidence. Conclusions: The effectiveness of ERAS in improving recovery indicates that hospitals could adopt the protocol to improve patients’ health and wellbeing. Future studies can focus more on standardizing the protocol’s elements.

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