Feasibility and outcomes of ERAS protocol in elective cT4 colorectal cancer patients: results from a single-center retrospective cohort study

World Journal of Surgical Oncology

Yongbo An¹  Krishn Khanna²  Leandro Siragusa³  Giuseppe S. Sica³  Bruno Sensi³  Daniele Cerbo³  Marzia Franceschilli³  Piero Rossi³  Michela Campanelli³  Vittoria Bellato⁴ 

[1] Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China;Department of Surgery, Rush University Medical Center, Chicago, IL, USA;Minimally Invasive Unit, Department of Surgery, Università “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy;Minimally Invasive Unit, Department of Surgery, Università “Tor Vergata”, Viale Oxford 81, 00133, Rome, Italy;Department of Colorectal Surgery, St Mark’s Academic Hospital, London, UK;

关键词: Colorectal cancer;    ERAS;    Fast track;    T4;    Enhanced recovery;   

DOI  :  10.1186/s12957-021-02282-7

来源: Springer

【 摘 要 】

BackgroundPrograms of Enhanced Recovery After Surgery reduces morbidity and shorten recovery in patients undergoing colorectal resections for cancer. Patients presenting with more advanced disease such as T4 cancers are frequently excluded from undergoing ERAS programs due to the difficulty in applying established protocols. The primary aim of this investigation was to evaluate the possibility of applying a validated ERAS protocol in patients undergoing colorectal resection for T4 colon and rectal cancer and to evaluate the short-term outcome.MethodsSingle-center, retrospective cohort study. All patients with a clinical diagnosis of stage T4 colorectal cancer undergoing surgery between November 2016 and January 2020 were treated following the institutional fast track protocol without exclusion. Short-term postoperative outcomes were compared to those of a control group treated with conventional care and that underwent surgical resection for T4 colorectal cancer at the same institution from January 2010 to October 2016. Data from both groups were collected retrospectively from a prospectively maintained database.ResultsEighty-two patients were diagnosed with T4 cancer, 49 patients were included in the ERAS cohort and 33 in the historical conventional care cohort. Both, the mean time of tolerance to solid food diet and postoperative length of stay were significantly shorter in the ERAS group than in the control group (3.14 ± 1.76 vs 4.8 ± 1.52; p < 0.0001 and 6.93 ± 3.76 vs 9.50 ± 4.83; p = 0.0084 respectively). No differences in perioperative complications were observed.ConclusionsResults from this cohort study from a single-center registry support the thesis that the adoption of the ERAS protocol is effective and applicable in patients with colorectal cancer clinically staged T4, reducing significantly their length of stay and time of tolerance to solid food diet, without affecting surgical postoperative outcomes.

【 授权许可】

CC BY