Meta-analysis shows ERAS care improves recovery and reduces complications in laparoscopic nephrectomy for renal cancer
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Key Takeaway
Consider ERAS protocols for laparoscopic nephrectomy, noting heterogeneity limits certainty on magnitude and generalizability.
A meta-analysis of randomized controlled and quasi-experimental studies assessed the impact of enhanced recovery after surgery (ERAS) protocols compared to traditional perioperative care. The analysis included 2,361 patients undergoing laparoscopic radical nephrectomy for renal cancer. Data were pooled to evaluate various secondary outcomes, including time to first anal exhaust, feeding, urination, defecation, out-of-bed activity, catheter and drainage tube removal, and overall length of hospital stay. Patient satisfaction and the overall incidence of postoperative total complications were also examined.
The pooled results indicate that postoperative recovery times and hospital stay were significantly earlier and shorter in the ERAS group compared to the traditional care group. Additionally, the overall incidence of postoperative total complications was lower, and patient satisfaction was higher in the ERAS group. Specific absolute numbers, effect sizes, and p-values were not reported in the source data provided.
Safety and tolerability data, including adverse events or discontinuations, were not reported for the interventions. A key limitation identified is the potential heterogeneity among the included studies. Due to this heterogeneity and the nature of the meta-analysis, the magnitude of the effects and generalizability beyond the specific included studies remain uncertain. Further validation by higher-quality research is recommended before broad implementation.
View Original Abstract ↓
BackgroundRenal carcinoma is a common malignant tumor of the urinary system worldwide. Given substantial evidence demonstrating the beneficial effects of enhanced recovery after surgery (ERAS) care on recovery following laparoscopic radical nephrectomy for renal cancer, in this study, we conducted a systematic review and meta-analysis to summarize relevant studies and evaluate the application value of ERAS care in this context.MethodsWe searched databases such as PubMed, Embase, The Cochrane Library, Web of Science, OVID, CNKI, Wanfang Data, VIP, and the China Biological Literature Database for clinical studies comparing ERAS care with traditional perioperative care in patients undergoing laparoscopic radical nephrectomy for renal cancer, up to December 2025. Two independent reviewers performed literature screening, data extraction, and quality assessment of the included studies. A cumulative meta-analysis was conducted using Stata version 12.0.ResultsA total of 26 relevant studies were included, comprising 24 randomized controlled studies and two quasi-experimental studies, involving 2,361 patients (1,172 in the ERAS care group and 1,189 in the traditional care group). The cumulative meta-analysis results indicated that patients receiving ERAS care experienced significantly earlier times to first anal exhaust, first feeding, first urination time after surgery, first defecation, catheter encumbrance time, first-time out-of-bed activity, length of hospital stay and removal time of drainage tube postoperatively. Furthermore, and postoperative hospital stay were shorter in the ERAS group. The ERAS group also demonstrated a lower overall incidence of postoperative total complications and higher patient satisfaction.ConclusionThe application of ERAS care in laparoscopic radical nephrectomy for renal cancer can accelerate postoperative recovery, shorten postoperative hospital stay, and reduce the incidence of postoperative complications. However, because of potential heterogeneity among the included studies, these conclusions warrant further validation by more high-quality research.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero, PROSPERO CRD420251159414.
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