Nonstrict and individual enhanced recovery after surgery (ERAS) in partial hepatectomy

Abstract

BackgroundWe aimed to evaluate postoperative recovery and short-term outcomes of patients undergoing partial hepatectomy managed with a nonstrict and individual enhanced recovery after surgery (ERAS) program.MethodsA retrospective analysis of 168 partial hepatectomy patients in our institution was included. The discharged day and the respective impact of element application throughout the duration were analyzed.ResultsWhen all the required elements of ERAS were fully implemented, the median discharge day was 6. The more deviation occurred, the more delayed the patient discharged (P < 0.01). Preoperative ASA score, basic conditions of patients and ages were revealed closely associated with discharge day (P < 0.001). Without or an early removal of tubes and early oral feeding reduced hospital stay statistically (P < 0.01). Early discharge of patients (<3 days) did not show an increased complication incidence or readmission (P > 0.05).ConclusionNonstrict and individual use of ERAS in partial hepatectomy reduced postoperative length of stay without increasing complication rate. Our study proposes a modulation of ERAS according to the needs and acceptance of patients. In a word, better optionally required rather than mandatorily meet.

Barriers to implementation of enhanced recovery after surgery (ERAS) by a multidisciplinary team in China: a multicentre qualitative study

“…Through a large number of randomised controlled trials, it has been proven that the implementation of ERAS can effectively reduce the pain of patients, hospitalisation costs and length of stay in the hospital without increasing the 30-day readmission rate and complications. [8][9][10][11] At present, the ERAS programme has been successfully applied to general, 12 orthopaedic, 10 urological 11 and other operations, 13 and many expert consensuses have been developed for each specialty, marking the maturity of the application of ERAS in China.…”

Safety and efficacy of enhanced recovery after surgery (ERAS) programs in patients undergoing hepatectomy: A prospective randomized controlled trial

“…Laparoscopic partial hepatectomy had the advantages of minor trauma, lighter body reaction and accelerated rehabilitation, which reflected more highlights of ERAS programs. In China, ERAS has been applied to many hepatobiliary surgery centers in the past 3 years . Since ERAS project started in August 2016, ERAS has been actively implemented to hepatectomy in our department.…”

“…In China, ERAS has been applied to many hepatobiliary surgery centers in the past 3 years. 7,8 Since ERAS project started in August 2016, ERAS has been actively implemented to hepatectomy in our department.…”

Transnasal Endoscopic Orbital Decompression Combined with an Enhanced Recovery after Surgery Protocol in Graves Ophthalmopathy

“…However, despite the many advantages, a purely endoscopic approach may also have several limitations, such as difficulty in removing the bone lateral to the inferior orbital nerve or anterior to the middle meatal antrostomy, and decompression of the medial wall and floor only may result in significant medial orbital prolapse, leading to diplopia [10]. In this regard, enhanced recovery after surgery (ERAS) refers to a series of modified measures applied during the perioperative period to accelerate postoperative recovery and was first introduced 15 years ago for colorectal surgery [11]. Specifically, ERAS can accelerate recovery, maintain body composition, and shorten discharge time without affecting morbidity by combining multimodality pathways such as anesthesia, surgery, nursing, and perioperative management.…”