BACKGROUND Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. METHODS Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. RESULTS A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR = 0.50, 95%CI: 0.33 to 0.75), postoperative length of stay (MD = -2.53, 95%CI: - 3.42 to - 1.65), time until first postoperative flatus (MD = -0.64, 95%CI: - 0.84 to - 0.45) and time until first postoperative defecation (MD = -1.10, 95%CI: - 1.74 to - 0.47) in patients who received ERAS, compared to conventional care. However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P = 0.10), surgical site infection (P = 0.42), postoperative anastomotic leakage (P = 0.45), readmissions (P = 0.31) and ileus (P = 0.25). CONCLUSIONS ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

中文翻译：

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上消化道手术术后增强恢复的应用：荟萃分析。

背景技术尽管增强的手术后恢复（ERAS）在手术领域已取得很大进展，但该指南指出，在上消化道手术中缺乏高质量的证据。方法检索2018年12月12日之前在四个涉及ERAS方案进行上消化道手术的电子数据库中进行的随机对照试验。主要终点为肺部感染，尿路感染，手术部位感染，术后吻合口漏和肠梗阻。次要终点是术后住院时间，从手术结束到第一次肠胀气和排便的时间以及再入院率。根据手术类型进行亚组分析。结果共纳入17项研究。荟萃分析的结果表明，肺部感染率（RR = 0.50，95％CI：0.33至0.75），术后住院时间（MD = -2.53，95％CI：-3.42至- 1.65），接受首次手术后肠胃气胀的患者的时间（MD = -0.64，95％CI：-0.84至-0.45）和首次术后排便的时间（MD = -1.10，95％CI：-1.74至-0.47）与传统护理相比，ERAS。但是，其他结局差异不显着。ERAS与传统护理之间在尿路感染率（P = 0.10），手术部位感染（P = 0.42），术后吻合口漏（P = 0.45），再入院（P = 0.31）和肠梗阻（P）方面无显着差异。 = 0.25）。结论ERAS方案可降低术后肺部感染的风险并加快患者康复时间。不过，