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Doesum, Willem van; Gard, Lilli; Son, Willem J. van; Sanders, Jan Stephan; Brilman, Annelies Riezebos; Niesters, Bert; Bemelman, Fréderike J.; Fijter, Hans W. de

doi:10.1111/tri.12210

Cited by 3 publications

(5 citation statements)

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“…Metaanalysis was possible for three papers. 25,29,30 Readmission was numerically lower in ERAS compared to standard of care (OR = 0.45, 95% CI = 0.19-1.10, P = .08, Figure 2); however, this was not significant. Heterogeneity was low (I 2 = 0%), although the confidence intervals for this domain remain large.…”

Section: Readmissionmentioning

confidence: 90%

“…Five studies evaluated readmission and no studies demonstrated a significant difference in readmission rates. 6,25,26,29,30 All of these studies evaluated laparoscopic procedures. The time point used was 30 days in three studies and not reported in two studies.…”

Section: Readmissionmentioning

confidence: 99%

“…Meta-analysis was possible for five laparoscopic studies, and there was no significant difference in complications (OR = 0.42, 95% CI 0.06-2.90, P = .38, Figure 2). 6,24,25,27,32 Heterogeneity was moderate (I 2 = 55%). This outcome was limited by the reporting of complications.…”

Section: Complicationsmentioning

confidence: 99%

“…Campsen et al 32 only measured urinary retention, Brown et al 25 only measured gastrointestinal dysfunction. Clavien-Dindo classifications of complications were included in only one study.…”

Section: Complicationsmentioning

confidence: 99%

“…for laparoscopic or open procedures. 6,25,29,31,32,34 Of the six studies investigating postoperative creatinine levels, three used ketorolac as part of their postoperative analgesia. 31,32,34 Ketorolac is a firstgeneration non-steroidal anti-inflammatory drug (NSAID) and has the potential to be nephrotoxic.…”

Section: Other Comparisonsmentioning

confidence: 99%

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A systematic review of living kidney donor enhanced recovery after surgery

Byrne

Mehmood

Summers

et al. 2021

Clinical Transplantation

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Enhanced recovery after surgery (ERAS) reduces complications and shortens hospital stay without increasing readmission or mortality. However, its role in living donor nephrectomy (LDN) has not yet been defined. Medline, Embase, CINAHL, PsycINFO, and Cochrane Central were searched prior to 08/01/21 for all randomized controlled and cohort studies comparing ERAS to standard of care in LDN. The study was registered on PROSPERO (CRD: CRD42019141706). One thousand, three hundred seventy-seven patients were identified from 14 studies (698 patients with ERAS and 679 patients without). There were considerable differences in the protocols used, and compliance with general ERAS recommendations was poor. Meta-analysis of laparoscopic procedures (including hand-and robot-assisted) revealed that duration of stay was significantly reduced by 0.98 days with ERAS (95% CI = 0.36-1.60, P = .002) and opiate requirement by 32.4 mg (95% CI = 1.1-63.7, P = .04). There was no significant difference n readmission rates or complications. Quality of evidence was low to moderate assessed using the GRADE tool. This review suggests there is a positive benefit of ERAS in laparoscopic LDN. However, there was considerable variation in ERAS protocols used, and the quality of evidence was low; as such, a guideline for ERAS in LDN should be developed and validated.

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Section: Readmissionmentioning

confidence: 90%