Enhanced Recovery After Surgery Pathway for Microsurgical Breast Reconstruction: a Systematic Review and Meta-Analysis

Background: Enhanced Recovery After Surgery pathway (ERAS) was introduced in 1997 as a multimodal approach to reduce preventable postoperative harm and shorten hospital length of stay (LOS). However, there is yet no widely accepted ERAS protocol for microsurgical breast reconstruction (mBR). This study aims to conduct a systematic review and a meta-analysis of the current literature on ERAS for mBR in regards to postoperative LOS and morbidity. Methods: We searched PubMed, Embase, Cochrane, Scopus and Web of Science for all studies published prior to June 2016 that contain original data investigating ERAS in mBR in relation to postoperative LOS and morbidity. Studies found were screened using eligibility criteria previously agreed upon. Meta-analysis, odds ratio and 95% confidence interval were used to pool acquired data. Results: The initial search identified 86 studies. Two independent screeners identified four original articles, with a pooled population of 676 patients. Length of stay in days was significantly shorter for patients on ERAS pathway (Mean Difference=-1.23, 95% CI -1.50, -0.96, p

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