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Surgical Endoscopy
Erschienen in: Surgical Endoscopy 6/2018

12.12.2017

Enhanced recovery care versus traditional care after laparoscopic liver resections: a randomized controlled trial

verfasst von: Xiao Liang, Hanning Ying, Hongwei Wang, Hongxia Xu, Minjun Liu, Haiyan Zhou, Huiqing Ge, Wenbin Jiang, Lijun Feng, Hui Liu, Yingchun Zhang, Zhiying Mao, Jianhua Li, Bo Shen, Yuelong Liang, Xiujun Cai

Erschienen in: Surgical Endoscopy | Ausgabe 6/2018

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Abstract

Background

Enhanced recovery after surgery (ERAS), with several evidence-based elements, has been shown to shorten length of hospital stay and reduce perioperative hospital costs in many operations. This randomized clinical trial was performed to compare complications and hospital stay of laparoscopic liver resection between ERAS and traditional care.

Methods

A randomized controlled trial was performed for laparoscopic liver resection from August 2015 to August 2016. Patients were randomly divided into ERAS group and traditional care group. The primary outcome was length of hospital stay (LOS) after surgery. Second outcomes included postoperative complications, hospital cost, and 30-day readmissions. Elements used in ERAS group included more perioperative education, nurse navigators, nutrition support for liver diseases, respiratory therapy, oral carbohydrate 2 h before operation, early mobilization and oral intake, goal-directed fluid therapy, less drainages, postoperative nausea and vomiting (PONV) prophylaxis and multimodal analgesia.

Results

The study included 58 (two conversion to laparotomy) patients in ERAS group and 61 (three conversion to laparotomy) patients in the traditional care group. Postoperative LOS was significantly shorter in the ERAS group than traditional care group (5 vs. 8 days; p < 0.001). ERAS program significantly reduced the hospital costs (CNY 45413.1 vs. 55794.1; p = 0.006) and complications (36.2 vs. 55.7%; p = 0.033). Duration till first flatus and PONV were significantly reduced in ERAS group. Pain control was better in ERAS (Visual analogue scale (VAS) POD1 (≥ 4) 19.0 vs. 39.3%, p = 0.017; VAS POD1 2.5 vs. 3.1, p = 0.010). There was no difference in the rate of 30-day readmissions (6.9 vs. 8.2%; p = 1.000).

Conclusion

ERAS protocol is feasible and safe for laparoscopic liver resection. Patients in ERAS group have less pain and complications.
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Metadaten
Titel
Enhanced recovery care versus traditional care after laparoscopic liver resections: a randomized controlled trial
verfasst von
Xiao Liang
Hanning Ying
Hongwei Wang
Hongxia Xu
Minjun Liu
Haiyan Zhou
Huiqing Ge
Wenbin Jiang
Lijun Feng
Hui Liu
Yingchun Zhang
Zhiying Mao
Jianhua Li
Bo Shen
Yuelong Liang
Xiujun Cai
Publikationsdatum
12.12.2017
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 6/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5973-3

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