To compare the influence of ERAS care on postoperative recovery with that of conventional care in abdominal wall reconstruction, we performed a systematic review and meta-analysis based on current literature.

PubMed, EMBASE and Cochrane were searched for studies published before April 2020 containing original data on the ERAS program for abdominal wall reconstruction. The effects of ERAS protocols and conventional care on length of stay (LOS), bowel recovery, postoperative complications and readmission were compared.

Four retrospective cohort studies with a total of 768 patients (345 in ERAS and 423 in the conventional care group) were identified. LOS was shorter with ERAS than with conventional care [mean difference (MD) -0.93 (-1.83--0.04), P=0.04]. ERAS patients had an earlier return of bowel function than the control [MD, -0.86 (-1.12--0.60); P<0.000 1]. Postoperative complications and readmission were comparable between the ERAS and conventional care groups.

The application of ERAS protocols in abdominal wall reconstruction surgery may reduce the average length of hospital stay and accelerate the recovery of bowel function. No statistically significant differences were found in the incidence of complications and readmission rates between the ERAS and conventional care groups. To further confirm the advantages of ERAS protocols and optimize them, large-scale randomized controlled trials are needed.