Retrospective cohort study of an enhanced recovery programme in oesophageal and gastric cancer surgery

Ann R Coll Surg Engl. 2015 Oct;97(7):502-7. doi: 10.1308/003588415X14181254789880.

Abstract

Introduction Enhanced recovery programmes have been established in some areas of elective surgery. This study applied enhanced recovery principles to elective oesophageal and gastric cancer surgery. Methods An enhanced recovery programme for patients undergoing open oesophagogastrectomy, total and subtotal gastrectomy for oesophageal and gastric malignancy was designed. A retrospective cohort study compared length of stay on the critical care unit (CCU), total length of inpatient stay, rates of complications and in-hospital mortality prior to (35 patients) and following (27 patients) implementation. Results In the cohort study, the median total length of stay was reduced by 3 days following oesophagogastrectomy and total gastrectomy. The median length of stay on the CCU remained the same for all patients. The rates of complications and mortality were the same. Conclusions The standardised protocol reduced the median overall length of stay but did not reduce CCU stay. Enhanced recovery principles can be applied to patients undergoing major oesophagogastrectomy and total gastrectomy as long as they have minimal or reversible co-morbidity.

Keywords: Enhanced recovery; Gastric neoplasms; Oesophageal neoplasms; Perioperative care; Surgical procedures.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Clinical Protocols
  • Elective Surgical Procedures* / mortality
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / surgery*
  • Esophagectomy* / mortality
  • Female
  • Follow-Up Studies
  • Gastrectomy* / mortality
  • Hospital Mortality
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Perioperative Care / methods*
  • Perioperative Care / standards
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Program Evaluation
  • Retrospective Studies
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / surgery*
  • Treatment Outcome