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Clinical and Translational Oncology

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01.09.2015 | Research Article

The effect of enhanced recovery program for patients undergoing partial laparoscopic hepatectomy of liver cancer

verfasst von: F. He, X. Lin, F. Xie, Y. Huang, R. Yuan

Erschienen in: Clinical and Translational Oncology | Ausgabe 9/2015

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Abstract

Objective

To analyze the results after the introduction of enhanced recovery after surgery (ERAS) protocols, a randomized study was performed to compare the outcomes of laparoscopic hepatectomy under ERAS or traditional care.

Methods

Patients undergoing laparoscopic hepatectomy from April 2014 to October 2014 were included and randomly divided into Control group (CG) and ERAS. Primary outcome was quality of life (QoL) and length of hospital stay (LOS). Secondary endpoints were percentage readmission, mortality, duration to first flatus, complications, hospital costs, conversions and blood loss.

Results

Thirteen patients withdrew after randomization. Eighty-six patients completed the study, 48 ERAS and 38 CG. Postoperative LOS was significantly reduced in ERAS [6 (4–8) versus 10 (7–15) days, P = 0.04]. First flatus occurred earlier in ERAS than CG [2(1–4) versus 3(2–5) days, P = 0.02]. The average perioperative charges were 9470 ± 1540 in CG and only 7742 ± 1200 in ERAS (P = 0.03), with no differences in readmission rate, blood loss, conversions to open surgery, mortality or surgical complications. The median AUC (area under a curve) of QoL was considerably improved in ERAS (P = 0.04).

Conclusions

This study suggests that ERAS is feasible and safe for laparoscopic hepatectomy.

Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606–17.PubMedCrossRef

Fayezizadeh M, Petro CC, Rosen MJ, Novitsky YW. Enhanced recovery after surgery pathway for abdominal wall reconstruction: pilot study and preliminary outcomes. Plast Reconstr Surg. 2014;134(4 Suppl 2):151S–9S.PubMedCrossRef

Lyon A, Payne CJ, Mackay GJ. Enhanced recovery programme in colorectal surgery: does one size fit all? World J Gastroenterol. 2012;18(40):5661–3.PubMedCentralPubMedCrossRef

Aarts MA, Okrainec A, Glicksman A, Pearsall E, Victor JC, McLeod RS. Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Surg Endosc. 2012;26(2):442–50.PubMedCrossRef

Kim JW, Kim WS, Cheong JH, Hyung WJ, Choi SH, Noh SH. Safety and efficacy of fast-track surgery in laparoscopic distal gastrectomy for gastric cancer: a randomized clinical trial. World J Surg. 2012;36(12):2879–87.PubMedCrossRef

Wang G, Jiang ZW, Xu J, Gong JF, Bao Y, Xie LF, et al. Fast-track rehabilitation program vs conventional care after colorectal resection: a randomized clinical trial. World J Gastroenterol. 2011;17(5):671–6.PubMedCentralPubMedCrossRef

Yang D, He W, Zhang S, Chen H, Zhang C, He Y. Fast-track surgery improves postoperative clinical recovery and immunity after elective surgery for colorectal carcinoma: randomized controlled clinical trial. World J Surg. 2012;36(8):1874–80.PubMedCentralPubMedCrossRef

Cuesta MA, Meijer S, Paul MA, de Brauw LM. Limited laparoscopic liver resection of benign tumors guided by laparoscopic ultrasonography: report of two cases. Surg Laparosc Endosc. 1995;5(5):396–401.PubMed

Shibata J, Ishihara S, Nishikawa T, Tanaka T, Tanaka J, Kiyomatsu T, et al. Minimally invasive surgery for rectal cancer. Nihon Shokakibyo Gakkai Zasshi. 2014;111(11):2105–12.PubMed

10.

van Gulik T. Open versus laparoscopic resection for liver tumours. HPB (Oxford). 2009;11(6):465–8.CrossRef

11.

Rockall TA, Demartines N. Laparoscopy in the era of enhanced recovery. Best Pract Res Clin Gastroenterol. 2014;28(1):133–42.PubMedCrossRef

12.

Abu Hilal M, Pearce NW. Laparoscopic left lateral liver sectionectomy: a safe, efficient, reproducible technique. Dig Surg. 2008;25(4):305–8.PubMedCrossRef

13.

van Dam RM, Wong-Lun-Hing EM, van Breukelen GJ, Stoot JH, van der Vorst JR, Bemelmans MH, et al. Open versus laparoscopic left lateral hepatic sectionectomy within an enhanced recovery ERAS(R) programme (ORANGE II-trial): study protocol for a randomised controlled trial. Trials. 2012;13:54.PubMedCentralPubMedCrossRef

14.

Dagher I, O’Rourke N, Geller DA, Cherqui D, Belli G, Gamblin TC, et al. Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg. 2009;250(5):856–60.PubMedCrossRef

15.

Lin DX, Li X, Ye QW, Lin F, Li LL, Zhang QY. Implementation of a fast-track clinical pathway decreases postoperative length of stay and hospital charges for liver resection. Cell Biochem Biophys. 2011;61(2):413–9.PubMedCentralPubMedCrossRef

16.

MacKay G, O’Dwyer PJ. Early discharge following liver resection for colorectal metastases. Scott Med J. 2008;53(2):22–4.PubMedCrossRef

17.

Sanchez-Perez B, Aranda-Narvaez JM, Suarez-Munoz MA, Eladel-Delfresno M, Fernandez-Aguilar JL, Perez-Daga JA, et al. Fast-track program in laparoscopic liver surgery: theory or fact? World J Gastrointest Surg. 2012;4(11):246–50.PubMedCentralPubMedCrossRef

18.

Schultz NA, Larsen PN, Klarskov B, Plum LM, Frederiksen HJ, Christensen BM, et al. Evaluation of a fast-track programme for patients undergoing liver resection. Br J Surg. 2013;100(1):138–43.PubMedCrossRef

19.

Jones C, Kelliher L, Dickinson M, Riga A, Worthington T, Scott MJ, et al. Randomized clinical trial on enhanced recovery versus standard care following open liver resection. Br J Surg. 2013;100(8):1015–24.PubMedCrossRef

20.

Langenhoff BS, Krabbe PF, Peerenboom L, Wobbes T, Ruers TJ. Quality of life after surgical treatment of colorectal liver metastases. Br J Surg. 2006;93(8):1007–14.PubMedCrossRef

21.

Shao Y, Zou LL, Zhou QH, Zhong DS, Guo FJ, Ma L. Fast-track surgery for gastroenteric neoplasms: a meta-analysis. Tumori. 2014;100(5):197e–203e.

22.

Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg. 2009;250(5):825–30.PubMedCrossRef

23.

Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection 2804 patients. Ann Surg. 2009;250(5):831–41.PubMedCrossRef

24.

Philp S, Carter J, Pather S, Barnett C, D’Abrew N, White K. Patients’ satisfaction with fast-track surgery in gynaecological oncology. Eur J Cancer Care (Engl). 2014. doi:10.1111/ecc.12254.

25.

Khan S, Gatt M, MacFie J. Enhanced recovery programmes and colorectal surgery: does the laparoscope confer additional advantages? Colorectal Dis. 2009;11(9):902–8.PubMedCrossRef

26.

Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth. 2002;89(4):622–32.PubMedCrossRef

27.

Gustafsson UO, Hausel J, Thorell A, Ljungqvist O, Soop M, Nygren J, et al. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg. 2011;146(5):571–7.PubMedCrossRef

28.

Wakeling HG, McFall MR, Jenkins CS, Woods WG, Miles WF, Barclay GR, et al. Intraoperative oesophageal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth. 2005;95(5):634–42.PubMedCrossRef

29.

Koea JB, Young Y, Gunn K. Fast track liver resection: the effect of a comprehensive care package and analgesia with single dose intrathecal morphine with gabapentin or continuous epidural analgesia. HPB Surg. 2009;2009:271986.PubMedCentralPubMedCrossRef

30.

Bagry HS, Raghavendran S, Carli F. Metabolic syndrome and insulin resistance: perioperative considerations. Anesthesiology. 2008;108(3):506–23.PubMedCrossRef

31.

Soop M, Carlson GL, Hopkinson J, Clarke S, Thorell A, Nygren J, et al. Randomized clinical trial of the effects of immediate enteral nutrition on metabolic responses to major colorectal surgery in an enhanced recovery protocol. Br J Surg. 2004;91(9):1138–45.PubMedCrossRef

32.

Stevens MF, de Nes L, Hollmann MW. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery (Br J Surg 2011; 98: 1068–1078). Br J Surg. 2011;98(12):1805 author reply 6.PubMedCrossRef

33.

Pearse R, Dawson D, Fawcett J, Rhodes A, Grounds RM, Bennett ED. Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial [ISRCTN38797445]. Crit Care. 2005;9(6):R687–93.PubMedCentralPubMedCrossRef

34.

Rahbari NN, Zimmermann JB, Schmidt T, Koch M, Weigand MA, Weitz J. Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery. Br J Surg. 2009;96(4):331–41.PubMedCrossRef

35.

Itou K, Fukuyama T, Sasabuchi Y, Yasuda H, Suzuki N, Hinenoya H, et al. Safety and efficacy of oral rehydration therapy until 2 h before surgery: a multicenter randomized controlled trial. J Anesth. 2012;26(1):20–7.PubMedCentralPubMedCrossRef

36.

Camera L, Calabrese M, Sarnelli G, Longobardi M, Rocco A, Cuomo R, et al. Pseudopneumoperitoneum in chronic intestinal pseudo-obstruction: a case report. World J Gastroenterol. 2011;17(24):2972–5.PubMedCentralPubMedCrossRef

37.

Alkari B, Owera A, Ammori BJ. Laparoscopic liver resection: preliminary results from a UK centre. Surg Endosc. 2008;22(10):2201–7.PubMedCrossRef

38.

Khan S, Wilson T, Ahmed J, Owais A, MacFie J. Quality of life and patient satisfaction with enhanced recovery protocols. Colorectal Dis. 2010;12(12):1175–82.PubMedCrossRef

39.

Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJ. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev. 2011;2:CD007635.PubMed

Titel: The effect of enhanced recovery program for patients undergoing partial laparoscopic hepatectomy of liver cancer
verfasst von: F. He
X. Lin
F. Xie
Y. Huang
R. Yuan
Publikationsdatum: 01.09.2015
Verlag: Springer Milan
Erschienen in: Clinical and Translational Oncology / Ausgabe 9/2015
Print ISSN: 1699-048X
Elektronische ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-015-1296-9

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The effect of enhanced recovery program for patients undergoing partial laparoscopic hepatectomy of liver cancer

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Objective

Methods

Results

Conclusions

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Methods

Results

Conclusions

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