Enhanced recovery after surgery nursing improves postoperative outcomes in laparoscopic radical nephrectomy: a cumulative meta-analysis

术后加速康复护理可改善腹腔镜根治性肾切除术后的预后:一项累积荟萃分析

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Abstract

BACKGROUND: Renal carcinoma is a common malignant tumor of the urinary system worldwide. Given substantial evidence demonstrating the beneficial effects of enhanced recovery after surgery (ERAS) care on recovery following laparoscopic radical nephrectomy for renal cancer, in this study, we conducted a systematic review and meta-analysis to summarize relevant studies and evaluate the application value of ERAS care in this context. METHODS: We searched databases such as PubMed, Embase, The Cochrane Library, Web of Science, OVID, CNKI, Wanfang Data, VIP, and the China Biological Literature Database for clinical studies comparing ERAS care with traditional perioperative care in patients undergoing laparoscopic radical nephrectomy for renal cancer, up to December 2025. Two independent reviewers performed literature screening, data extraction, and quality assessment of the included studies. A cumulative meta-analysis was conducted using Stata version 12.0. RESULTS: A total of 26 relevant studies were included, comprising 24 randomized controlled studies and two quasi-experimental studies, involving 2,361 patients (1,172 in the ERAS care group and 1,189 in the traditional care group). The cumulative meta-analysis results indicated that patients receiving ERAS care experienced significantly earlier times to first anal exhaust, first feeding, first urination time after surgery, first defecation, catheter encumbrance time, first-time out-of-bed activity, length of hospital stay and removal time of drainage tube postoperatively. Furthermore, and postoperative hospital stay were shorter in the ERAS group. The ERAS group also demonstrated a lower overall incidence of postoperative total complications and higher patient satisfaction. CONCLUSION: The application of ERAS care in laparoscopic radical nephrectomy for renal cancer can accelerate postoperative recovery, shorten postoperative hospital stay, and reduce the incidence of postoperative complications. However, because of potential heterogeneity among the included studies, these conclusions warrant further validation by more high-quality research. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero, PROSPERO CRD420251159414.

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