Impact of Enhanced Recovery After Surgery on Long-Term Outcomes and Postoperative Recovery in Patients Undergoing Hepatectomy: A Retrospective Cohort Study

被引:4
|
作者
Zhang, Zhao [1 ]
Gu, Weidong [2 ]
Zhang, Yijing [2 ]
机构
[1] Fudan Univ, Nursing Dept, Huadong Hosp, Shanghai 200040, Peoples R China
[2] Fudan Univ, Dept Anesthesiol, Huadong Hosp, 221 West Yanan Rd, Shanghai 200040, Peoples R China
来源
关键词
hepatectomy; enhanced recovery after surgery; length of stay; overall survival; disease-free survival; COLORECTAL SURGERY; LENGTH;
D O I
10.2147/CMAR.S301859
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The aim of this study was to evaluate the effects of implementation of the enhanced recovery after surgery (ERAS) program on postoperative recovery and the long-term prognosis in patients who underwent hepatectomy. Methods: This retrospective study enrolled patients who underwent hepatectomy from January 2015 to December 2018 in Huadong Hospital Affiliated to Fudan University. Since June 2016, a 24-point ERAS protocol has been implemented for patients who underwent hepatic resection. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes included length of stay (LOS), and incidence of postoperative complications. Results: A total of 1143 patients were enrolled in this study. After propensity score matching (PSM), there was no significant difference in patients' demographic characteristics. The DFS at 1., 3 years in ERAS group was higher than in non-ERAS group (96.3% vs 88.9% for 1 year, P=0.012; 58.9% vs 46.7% for 3 years, P=0.007). The OS at 1, 3 years in ERAS group was higher than in non-ERAS group (93.1% vs 89.3% for 1 year, P=0.041; 68.7% vs 61.2% for 3 years, P=0.035). In addition, the patients in ERAS group had lower incidences of postoperative hemorrhage, bile leak, and postoperative deep vein thrombosis/pulmonary embolism (DVT/PE), decreased 30-day readmission rate and total readmission rate, and shorter LOS. Conclusion: ERAS program could be safely applied to patients who underwent hepatectomy thereby improving their recovery and prolonging OS and DFS.
引用
收藏
页码:2681 / 2690
页数:10
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