Enhanced recovery after vascular surgery

INTRODUCTION: A multimodal perioperative care measure, the enhanced recovery after surgery (ERAS) method, is intended to accomplish early recovery following surgical procedures. It aims to preserve preoperative organ function and mitigate the significant stress response that typically occurs during recovery.EVIDENCE ACQUISITION: The goal of this systematic review and meta-analysis was to evaluate the advantages of enhanced recovery in the scope of vascular surgery. Following PRISMA Guidelines, a systematic search was conducted on various electronic reference databases (Web of Sciences, PubMed and Cochrane library). The keywords employed were (“Enhanced Recovery After Surgery” OR “ERAS”) AND (vascular) AND (“surgery” OR “operation” OR “procedure”). Inclusion criteria are articles published in English, and full-text was available, published between 2013-2023. Data was obtained on hospitalization duration, in hospital mortality, and post-surgical morbidity.EVIDENCE SYNTHESIS: Five hundred seventeen articles were identified and seven papers involving 1954 patients included for systematic review. The incidence of postoperative morbidity demonstrated a significant reduction when utilizing the ERAS approach in comparison to non-ERAS protocols (OR=0.21 [95%CI, 0.08 to 0.54], P=0.001). Additionally, the implementation of an ERAS protocol resulted in a notable reduction in hospitalization duration (MD=-0.59 [95%CI, -1.13 to -0.04], P=0.04). Furthermore, no significant difference was identified in hospital mortality rates.CONCLUSIONS: The multimodal perioperative care approach known as Enhanced Recovery After Surgery (ERAS) method is intended to facilitate immediate postoperative recovery by safeguarding preoperative organ function and reducing the visceral stress response post-surgery. The utilization of ERAS, coupled with enhanced perioperative care, brings substantial advantages to patients undergoing vascular surgery as well as those undergoing a range of other surgical specialties.