Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center

Desiderio, Jacopo; Stewart, Camille L.; Sun, Virginia; Melstrom, Laleh G.; Warner, Susanne G.; Lee, Byrne; Schoellhammer, Hans F.; Trisal, Vijay; Paz, Benjamin; Fong, Yuman; Woo, Yanghee

doi:10.5230/jgc.2018.18.e24

Cited by 32 publications

(22 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Minimally invasive surgery has been widely used and several studies, including randomized trials have demonstrated the higher efficacy of laparoscopic and robot-assisted surgeries compared to open surgery [163164]. Anesthesia techniques and perioperative nutritional support have enhanced postoperative recovery after the guidelines for gastric cancer surgery were published [165166]. Laboratory and immune parameters are reported to be a predictor of outcomes in several studies, including our earlier studies [3101115].…”

Section: Inflammation and Gastric Cancermentioning

confidence: 99%

Biomarkers for Evaluating the Inflammation Status in Patients with Cancer

Güner

Kim

2019

J Gastric Cancer

View full text Add to dashboard Cite

Inflammation can be a causative factor for carcinogenesis or can result from a consequence of cancer progression. Moreover, cancer therapeutic interventions can also induce an inflammatory response. Various inflammatory parameters are used to assess the inflammatory status during cancer treatment. It is important to select the most optimal biomarker among these parameters. Additionally, suitable biomarkers must be examined if there are no known parameters. We briefly reviewed the published literature for the use of inflammatory parameters in the treatment of patients with cancer. Most studies on inflammation evaluated the correlation between host characteristics, effect of interventions, and clinical outcomes. Additionally, the levels of C-reactive protein, albumin, lymphocytes, and platelets were the most commonly used laboratory parameters, either independently or in combination with other laboratory parameters and clinical characteristics. Furthermore, the immune parameters are classically examined using flow cytometry, immunohistochemical staining, and enzymelinked immunosorbent assay techniques. However, gene expression profiling can aid in assessing the overall peri-interventional immune status. The checklists of guidelines, such as STAndards for Reporting of Diagnostic accuracy and REporting recommendations for tumor MARKer prognostic studies should be considered when designing studies to investigate the inflammatory parameters. Finally, the data should be interpreted after adjusting for clinically important variables, such as age and cancer stage.

show abstract

Section: Inflammation and Gastric Cancermentioning

confidence: 99%

Biomarkers for Evaluating the Inflammation Status in Patients with Cancer

Güner

Kim

2019

J Gastric Cancer

View full text Add to dashboard Cite

show abstract

“…In a subsequent randomized trial, shorter hospital stay has also been demonstrated in an enhanced recovery group (median 10 days vs. 9 days, p= 0.037) (31). Besides, in a recent study from the United States, the ERAS group has demonstrated shorter hospital stay with a mean difference of 2.3 days (mean 7.8 ± 3.6 days vs. 5.5 ± 2.0 days, p= 0.010) (18). The only study that showed that the ERAS program did not affect the length of hospital stay was the study published in Japan in 2012 (32).…”

Section: Discussionmentioning

confidence: 90%

“…However, gastrectomy for gastric cancer remains a high-risk procedure with significant morbidity and mortality (13,14). Clinical pathway has also been used for gastric cancer surgery, and studies have demonstrated improvement in peri-operative outcomes (15)(16)(17)(18). Enhanced Recovery After Surgery (ERAS) protocol is an evidence-based model of standardized clinical pathway system, which has been considered safe and effective in a recent meta-analysis in gastrectomy for gastric cancer patients (19).…”

Section: Introductionmentioning

confidence: 99%

The efficacy of clinical pathway in gastric cancer surgery

Güner¹

2020

Turk J Surg

View full text Add to dashboard Cite

Objective: Clinical pathways are useful tools for surgical quality improvement and better peri-operative clinical outcomes for patients undergoing major surgery. This study aimed to evaluate the influence of clinical pathway on early postoperative outcomes for gastric cancer patients. Material and Methods: The study was designed as a retrospective cohort observational study. Patients who had undergone curative gastrectomy for gastric cancer were evaluated by using the gastric cancer database, which was prospectively maintained. The patients were divided into two groups based on the date when the clinical pathway was first used: The control group (May 2015-May 2016) and the clinical pathway group (June 2016-December 2017). Early postoperative outcomes including the length of hospital stay, start of the day of diet, and 30-day complications including reoperation, and operative mortality were compared after propensity score matching. Results: A total of 101 patients were analyzed, and the data of 70 patients (35 patients in each group) were compared after matching. Clinical pathway group demonstrated shorter hospital stay, earlier nasogastric tube removal, and start of earlier liquid/soft diet. Overall complication rate was lower in the clinical pathway group, while there was no statistically significant difference in major complication rates. No statistically significant difference was observed between the groups in terms of reoperation and operative mortality. Conclusion: Clinical pathway may shorten the postoperative length of hospital stay and reduce the overall complication rate without increasing major morbidity in patients undergoing elective gastric cancer surgery.

show abstract

“…Enhanced Recovery After Surgery (ERAS) programs are evidence-based, multidisciplinary, surgical care pathways developed to expedite recovery and improve patient outcomes after elective surgery (Desiderdio et al 2018 ; McConnell et al 2018 ; Brown et al 2018 ; Ban et al 2019 ). ERAS, comprised of several specific, evidence-based protocols, allows for the standardization of surgical patient care preoperatively, intraoperatively, and postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Types of surgical patients enrolled in enhanced recovery after surgery (ERAS) programs in the USA

et al. 2021

View full text Add to dashboard Cite

Background Enhanced Recovery After Surgery (ERAS) programs have gained traction across US hospitals in the past two decades. Initially implemented for elective colorectal surgical procedures, ERAS has expanded to a variety of surgical service lines. There is little information regarding the extent to which various surgical service lines use ERAS. Methods A survey was performed to describe the prevalence of ERAS programs across surgical service lines in the USA. The survey had questions regarding the number of ERAS programs, operating rooms (ORs) and presence of anesthesia and/or surgery residency program at an institution. The survey was administered electronically to members of the American Society for Enhanced Recovery (ASER) and manually to participants at the 2018 Perioperative Quality and Enhanced Recovery Conference in San Francisco, CA. Results Responses were received from 88 unique institutions. The most commonly reported surgical service lines were colorectal (87%), gynecology (51%), orthopedic (49%), surgical oncology (39%), and urology (35%). A significant positive association was observed between the number of ORs and the number ERAS programs (Spearman’s Rho 0.5, p<0.0001). Furthermore, institutions that reported an anesthesia and/or surgery residency program had more ERAS programs (mean 5.0 ± 3.2) compared to those that did not (mean 2.0 ± 2.0) (Wilcoxon rank sum p< 0.001). Conclusions ERAS has expanded to a large extent outside of the colorectal surgery service line with increases notable in orthopedic surgery, obstetric/gynecology, surgical oncology, and urology procedures. Institutions with a higher number of ORs and the presence of an anesthesia and/or surgery residency program are associated with an increased number of ERAS programs.

show abstract

Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center

Cited by 32 publications

References 31 publications

Biomarkers for Evaluating the Inflammation Status in Patients with Cancer

Biomarkers for Evaluating the Inflammation Status in Patients with Cancer

The efficacy of clinical pathway in gastric cancer surgery

Types of surgical patients enrolled in enhanced recovery after surgery (ERAS) programs in the USA

Contact Info

Product

Resources

About