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Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Page 44
JOINT EVENT
Pediatric Gastro 2018
Digestive Diseases 2018
October 22-23, 2018
October 22-23, 2018 Berlin, Germany
3
rd
International Conference on
Digestive and Metabolic Diseases
Pediatric Gastroenterology Hepatology & Nutrition
13
th
International Conference on
&
Fasttrack program in liver resection: Aprisma-compliant systematic review and meta-analysis
Emad Ali
Marche Polytechnic University, Ancona, Italy
Sohag University, Egypt
Background:
FT program (FT) is a multimodal approach used to enhance postoperative rehabilitation and accelerate recovery.
It was 1st described in open heart surgery, then modified and applied successfully in colorectal surgery. FT program was
described in liver resection for the 1st time in 2008. Although the program has become widely accepted, it has not yet been
considered the standard of care in liver surgery.
Objectives:
we performed this systematic review and meta analysis to evaluate the impact of using the FT program compared
to the traditional care (TC), on the main clinical and surgical outcomes for patients who underwent elective liver resection.
Methods:
PubMed/Medline, Scopus, and Cochran databases were searched to identify eligible articles that compared FT with
TC in elective liver resection to be included in this study. Subgroup meta-analysis between laparoscopic and open surgical
approaches to liver resection was also conducted. Quality assessment was performed for all the included studies. Odds ratios
(ORs) and mean differences (MDs) were considered as a summary measure of evaluating the association in this meta-analysis
for dichotomous and continuous data, respectively. A 95% confidence interval (CI) was reported for both measures. I2 was
used to assess the heterogeneity across studies.
Results:
From 2008 to 2015, 3 randomized controlled trials (RCTs) and 5 cohort studies were identified, including 394 and
416 patients in the FT and TC groups, respectively. The length of hospital stay (LoS) was markedly shortened in both the
open and laparoscopic approaches within the FT program (P<0.00001). The reduced LoS was accompanied by accelerated
functional recovery (P=0.0008) and decreased hospital costs, with no increase in readmission, morbidity, or mortality rates.
Moreover, significant results were found within the FT group such as reduced operative time (P=0.03), lower intensive care
unit admission rate (P<0.00001), early bowel opening (P_0.00001), and rapid normal diet restoration (P_0.00001).
Conclusion:
FT program is safe, feasible, and can be applied successfully in liver resection. Future RCTs on controversial issues
such as multimodal analgesia and adherence rate are needed. Specific FT guidelines should be developed for liver resection.
dr.emadali@hotmail.comJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C7-083