Implementation of Enhanced Recovery (ERAS) in Colorectal Surgery Has a Positive Impact on Non-ERAS Liver Surgery Patients.

Détails

Ressource 1Télécharger: 26666423.pdf (452.61 [Ko])
Etat: Serval
Version: Author's accepted manuscript
ID Serval
serval:BIB_F99875118320
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Implementation of Enhanced Recovery (ERAS) in Colorectal Surgery Has a Positive Impact on Non-ERAS Liver Surgery Patients.
Périodique
World Journal of Surgery
Auteur(s)
Labgaa I., Jarrar G., Joliat G.R., Allemann P., Gander S., Blanc C., Hübner M., Demartines N.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
40
Numéro
5
Pages
1082-1091
Langue
anglais
Résumé
BACKGROUND: Enhanced recovery after surgery (ERAS) reduces complications and hospital stay in colorectal surgery. Thereafter, ERAS principles were extended to liver surgery. Previous implementation of an ERAS program in colorectal surgery may influence patients undergoing liver surgery in a non-ERAS setting, on the same ward. This study aimed to test this hypothesis.
METHODS: Retrospective analysis based on prospective data of the adherence to the institutional ERAS-liver protocol (compliance) in three cohorts of consecutive patients undergoing elective liver surgery, between June 2010 and July 2014: before any ERAS implementation (pre-ERAS n = 50), after implementation of ERAS in colorectal (intermediate n = 50), and after implementation of ERAS in liver surgery (ERAS-liver n = 74). Outcomes were functional recovery, postoperative complications, hospital stay, and readmissions.
RESULTS: The three groups were comparable for demographics; laparoscopy was more frequent in ERAS-liver (p = 0.009). Compliance with the enhanced recovery protocol increased along the three periods (pre-ERAS, intermediate, and ERAS-liver), regardless of the perioperative phase (pre-, intra-, or postoperative). ERAS-liver group displayed the highest overall compliance rate with 73.8 %, compared to 39.9 and 57.4 % for pre-ERAS and intermediate groups (p = 0.072/0.056). Overall complications were unchanged (p = 0.185), whereas intermediate and ERAS-liver groups showed decreased major complications (p = 0.034). Consistently, hospital stay was reduced by 2 days (p = 0.005) without increased readmissions (p = 0.158).
CONCLUSIONS: The previous implementation of an ERAS protocol in colorectal surgery may induce a positive impact on patients undergoing non-ERAS-liver surgery on the same ward. These results suggest that ERAS is safely applicable in liver surgery and associated with benefits.
Pubmed
Web of science
Open Access
Oui
Création de la notice
31/12/2015 12:17
Dernière modification de la notice
09/05/2019 3:45
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