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

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 hepatec...

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Bibliographic Details
Published inCancer management and research Vol. 13; p. 2681
Main Authors Zhang, Zhao, Gu, Weidong, Zhang, Yijing
Format Journal Article
LanguageEnglish
Published Dove Medical Press Limited 31.03.2021
Subjects
Analysis
Complications and side effects
Development and progression
Medical research
Medicine, Experimental
Patient outcomes
Prognosis
Pulmonary embolism
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Summary: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. Keywords: hepatectomy, enhanced recovery after surgery, length of stay, overall survival, disease-free survival
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S30l859