[Meta-analysis on safety of application of enhanced recovery after surgery to laparoscopic bariatric surgery].
Bibliographic record
Abstract
OBJECTIVE: To systematically review the safety of application of enhanced recovery after surgery(ERAS) to laparoscopic bariatric surgery. METHODS: The randomized controlled trials (RCTs) or case-controlled trials concerning application of ERAS principles in bariatric surgery were collected by searching several national and international online databases, including PubMed, Cochrane Library, CNKI, EMBASE and Wanfang databases. Data collection was completed in October 2016. The ERAS protocol covered three phases (preoperative, intraoperative, and postoperative), including preoperative counseling, reduced fasting, early ambulation, early oral feeding, etc. The endpoints included at least one of the following parameters: length of stay (LOS), operation time, readmission rate within 30 days, morbidity of postoperative complication (major/minor), and reoperation rate within 30 days. The quality of enrolled literatures was evaluated according to Cochrane Handbook and Newcastle-Ottawa Scale. RevMan 5.2 software was applied to perform meta analysis. The weighted mean difference (WMD) was used to combine the statistics for the measurement data, and the ratio and its 95% confidence interval were used to combine the statistics for the counting data. Subgroup analysis was conducted based on the quality of the enrolled literatures for the results of high heterogeneity. RESULTS: A total of 7 studies, including 1 randomized controlled trail and 6 case-control studies, with 3264 patients were enrolled. Among the 3264 patients, 2051 received ERAS management (ERAS group) and 1213 received traditional perioperative management (control group). Meta analysis showed that compared with control group, ERAS group had shorter operative time (WMD=-17.56, 95%CI: -29.50 to -5.62, P=0.00), shorter length of hospital stay (WMD=-1.11, 95%CI: -1.31 to -0.92,P=0.00). There were no statistically significant differences between the two groups in the morbidity of postoperative major complication(OR=1.21, 95%CI:0.87 to 1.69, P=0.26) or minor complication (OR=1.25, 95%CI:0.99 to 1.58, P=0.06), re-admission rate within 30 days (OR=1.07, 95%CI: 0.81 to 1.43, P=0.63) and re-operation rate within 30 days(OR=1.33, 95%CI: 0.84 to 2.11, P=0.23). CONCLUSION: Application of ERAS protocols to bariatric surgery is safe and feasible, which can also reduce length of hospital stay and operative time, and accelerate recovery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.043 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.039 |
| Bibliometrics | 0.009 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".