Evidence map›Paper›PMID 31974853›Full record

SynthesisEsophagus : official journal of the Japan Esophageal Society2020

Enhanced recovery pathways vs standard care pathways in esophageal cancer surgery: systematic review and meta-analysis.

Tania Triantafyllou, Michael T Olson, Dimitrios Theodorou, Dimitrios Schizas, Saurabh Singhal

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Esophagus : official journal of the Japan Esophageal Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 4 pooled it
9.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 60 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Early versus the traditional start of oral intake following esophagectomy for esophageal cancer: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022
    Pooled it
  4. [Enhanced recovery after surgery-Does the ERAS concept keep its promises].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2021
    Pooled it
  5. Trial
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  8. Review
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  11. Article
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  14. Esophageal cancer practice guidelines 2022 edited by the Japan Esophageal Society: part 2.Esophagus : official journal of the Japan Esophageal Society · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 3 countries.

Tania Triantafyllou1st Propaedeutic Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece.
Michael T OlsonUniversity of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.
Dimitrios Theodorou1st Propaedeutic Department of Surgery, Hippocration General Hospital of Athens, University of Athens, Athens, Greece.
Dimitrios SchizasFirst Department of Surgery, Laikon General Hospital of Athens, Athens, Greece.
Saurabh SinghalDepartment of GI Surgery and Liver Transplantation, Indraprastha Apollo Hospital, New Delhi, India. drsaurabhsinghal@gmail.com.ORCID 0000-0003-3829-5206
National and Kapodistrian University of Athens · GRIndraprastha Apollo Hospitals · INLaiko General Hospital of Athens · GRUniversity of Arizona · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Enhanced recovery after surgery (ERAS) protocols vs standard care pathways after esophagectomy for malignancy have gained wide popularity among surgeons. However, the current literature is still lacking level-I evidence to show a clear superiority of one approach. The present study is a detailed systematic review and meta-analysis of the published trials. A systematic review of literature databases was conducted for randomized controlled trials (RCTs) and non-randomized, prospective, comparative studies between January 1990 and September 2019, comparing ERAS pathway group with standard care for esophageal resection for esophageal cancer. Mean difference (MD) for continuous variables and odds ratio (OR) or risk difference (RD) for dichotomous variables with 95% confidence interval (CI) were used. Between-study heterogeneity was evaluated. Eight studies with a total of 1133 patients were included. Hospital stay [Standard mean difference (Std. MD) = - 1.92, 95% CI - 2.78, - 1.06, P < 0.0001], overall morbidity (OR 0.68, CI 0.49, 0.96, P = 0.03), pulmonary complications (OR 0.45, CI 0.31, 0.65, P < 0.0001), anastomotic leak rate (OR 0.37, CI 0.18, 0.74, P = 0.005), time to first flatus and defecation (Std. MD = -5.01, CI - 9.53, - 0.49, P = 0.03), (Std. MD = - 1.36, CI - 1.78, - 0.94, P < 0.00001) and total hospital cost (Std. MD = - 1.62, CI - 2.24, - 1.01, P < 0.00001) favored the ERAS group. Patients who undergo ERAS have a clear benefit over the standard care protocol. However, existing protocols in different centers are followed by great variability, while the evaluated parameters suffer from significant heterogeneity. A well-formulated, standardized protocol should be standard-of-care at all centers.

Indexed as

AdultAgedAnastomotic LeakData ManagementDefecationEnhanced Recovery After SurgeryEsophageal NeoplasmsEsophagectomyFemaleFlatulenceHospital CostsHumansLength of StayLung DiseasesMaleMiddle AgedEnhanced-recovery after surgeryEsophageal cancerEsophagectomyFast-track protocols

Identifiers

PMID31974853
OpenAlexW3001150596

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.