加速康复外科在腹腔镜全子宫切除术围手术期应用效果的Meta分析OA

Objective:To systematically evaluate the effect of enhanced recovery after surgery(ERAS)in the perioperative pe-riod of laparoscopic total hysterectomy(LTH).Methods:Randomized controlled trials regarding the application of ERAS in the peri-operative period of LTH were systematically searched in domestic and international databases,with the search period from the establish-ment of the databases to Oct.2025.Meta-analysis was performed using RevMan 5.4 software for the studies that met the inclusion crite-ria.Results:A total of 17 studies involving 2660 patients were included,among which 1332 patients were in the ERAS group and 1328 patients were in the conventional group.The meta-analysis results showed that compared with the conventional group,the ERAS group had shorter operative time(MD=-5.13,95%CI=-8.41～-1.84,P=0.002),less intraoperative blood loss(MD=-4.75,95%CI=-8.41～-1.09,P=0.01),earlier first ambulation time(MD=-6.82,95%CI=-8.97～-4.68,P<0.00001),earlier first anal exhaust time(MD=-4.84,95%CI=-6.21～-3.48,P<0.00001),earlier time to oral intake(MD=-10.06,95%CI=-15.91～-4.21,P=0.0007),shorter duration of urinary catheterization(MD=-6.73,95%CI=-10.38～-3.08,P=0.0003),lower anxiety score(MD=-7.38,95%CI=-13.17～-1.58,P=0.01),lower pain scores at 24 h after operation(MD=-1.31,95%CI=-1.83～-0.79,P<0.00001),lower complication rate(OR=0.41,95%CI=0.32～0.53,P<0.00001),shorter hospital stay(MD=-1.56,95%CI=-1.98～-1.13,P<0.00001),and less hospitalization cost(MD=-0.20,95%CI=-0.25～-0.15,P<0.00001).Conclusions:The application of ERAS in the perioperative period of LTH can safely and effectively promote the rapid recovery of patients.