Improving the Surgical Outcomes after Liver Resection with ERAS Program

J Med Assoc Thai. 2017 Apr;100(4):435-40.

Abstract

Background: Enhanced recovery after surgery (ERAS) has been accepted as the program to improve the surgical outcomes. This program has been increasingly utilized in liver resection.

Objective: To evaluate the outcomes of patients underwent liver resection by applying ERAS program.

Material and method: All patients underwent liver resection between January 2007 and April 2011 at King Chulalongkorn Memorial Hospital were included into the present study. Patients’ characteristics, preoperative factors, operative data, postoperative care that correlated to ERAS components, and postoperative outcomes were recorded. Outcomes including postoperative length of stay (LOS), intensive care unit (ICU) stay, complications, rate of reoperation, interventional treatment, and mortality were compared between patients in ERAS group (applied ERAS components >4) and conventional group (applied ERAS components <4).

Results: Three hundred forty seven patients were enrolled in present the study. There were 165 and 182 patients in ERAS and conventional groups, respectively. When compared between these two groups, ERAS group had better postoperative LOS (7 days vs. 10 days; p = 0.0001), ICU stay (0 days vs. 1 days; p = 0.0001), reoperation rate (1.2% vs. 4.9%; p = 0.047) and reintervention rate (15% vs. 27%; p = 0.005). There were no significant differences in complication rate (31% vs. 40%; p = 0.096) and mortality rate (0.6% vs. 1.1%; p = 0.62).

Conclusion: ERAS program improves the surgical outcomes in patients who underwent liver resection.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / surgery*
  • Carcinoma, Hepatocellular / surgery*
  • Case-Control Studies
  • Cholangiocarcinoma / surgery*
  • Clinical Protocols
  • Colorectal Neoplasms / pathology*
  • Female
  • Hepatectomy / methods*
  • Humans
  • Intensive Care Units
  • Length of Stay / statistics & numerical data*
  • Liver
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Metastasectomy / methods
  • Middle Aged
  • Mortality
  • Perioperative Care / methods*
  • Postoperative Complications / epidemiology*
  • Quality Improvement
  • Reoperation
  • Retrospective Studies
  • Treatment Outcome