Enhanced Recovery After Surgery (ERAS®) protocol in patients undergoing laparoscopic resection for stage IV colorectal cancer

World Journal of Surgical Oncology

Research

Michał Pędziwiatr¹  Michał Kisielewski¹  Michał Natkaniec¹  Piotr Major¹  Mateusz Wierdak¹  Maciej Matłok¹  Andrzej Budzyński¹  Magdalena Pisarska¹ 

[1] 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Kraków, Poland;Department of Endoscopic, Metabolic and Soft Tissue Tumors Surgery, Jagiellonian University Medical College, Kopernika 21, 31-501, Kraków, Poland;

关键词: Fast-track surgery;    Colorectal cancer;    Laparoscopy;    Enhanced recovery after surgery;    Perioperative care;   

DOI  :  10.1186/s12957-015-0745-9

 received in 2015-08-19, accepted in 2015-11-27,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundThere is strong evidence for the use of Enhanced Recovery After Surgery (ERAS) protocol with colorectal surgery. However, in most studies on ERAS, patients with stage IV colorectal cancer (CRC) are commonly excluded. It is not certain if the ERAS protocol combined with laparoscopy improves outcomes in this group of patients as well.The aim of the study is to assess the feasibility of the ERAS protocol implementation in patients operated laparoscopically due to stage IV CRC.MethodsA prospective analysis of patients undergoing laparoscopic colorectal surgery was performed. Group 1 included patients with stages I–III, and group 2 included patients with stage IV CRC. Demographic, surgical factors, length of stay (LOS), complications, readmissions, ERAS implementation and early postoperative recovery were compared between the groups.ResultsGroup 1 included 168 patients, and group 2 included 20 patients. There was no difference in the age, sex, BMI, ASA, cancer localisation or surgical parameters. No statistically significant difference was noted in complications (26.8 vs 20 %, p = 0.51344), LOS (4.7 vs 5.7 days, p = 0.28228) or readmissions (6 vs 10 %, p = 0.48392). The ERAS protocol compliance was 86.3 and 83.0 %, respectively (p = 0.17158).ConclusionsImplementation of the ERAS protocol and laparoscopic surgery among patients with stage IV CRC is feasible and provides similar short-term clinical outcomes and recovery as with patients with stages I–III.

【 授权许可】

CC BY   
© Pędziwiatr et al. 2015