The effect of the enhanced recovery programme on long-term survival following liver resection for colorectal liver metastases

Abstract

Background Enhanced recovery programmes are associated with improved short-term outcomes following liver surgery. The impact of enhanced recovery programmes on medium- and long-term outcomes is incompletely understood. This study aimed to assess the impact of an enhanced recovery programme on long-term survival in patients undergoing surgery for colorectal liver metastases. Methods At a tertiary hepatobiliary centre, we analysed short-, medium- and long-term outcomes in consecutive patients undergoing liver resection for colorectal liver metastases. A five-year retrospective review was carried out comparing the enhanced recovery programme to standard care. Results A total of 172 patients were included in the analysis: 87 on standard care and 85 on an enhanced recovery programme. Open surgery was performed in 122 patients: 74 (85.1%) and 48 (56.5%) patients in the standard care and enhanced recovery programme, respectively (p < 0.001). There was a significant reduction in the median (IQR) length of hospital stay in the enhanced recovery programme compared with standard care (7 (5) days vs. 8 (3) days, p = 0.0009). There was no significant difference in survival between standard care and the Enhanced Recovery Programme at one (p = 0.818), three (p = 0.203), and five years (p = 0.247). Conclusion An enhanced recovery programme was associated with a reduced length of hospital stay. There was no effect on the one-, three- and five-year survival.

Transforming Bariatric Surgery Outcomes: The Pivotal Role of Enhanced Recovery After Surgery (ERAS) Protocols in Patient-Centered Care

“…Despite the extensive scope of our review, it is essential to acknowledge its limitations. The variability in healthcare systems, as discussed by Lambert et al [ 19 ], could impact the implementation and efficacy of ERAS protocols in different regional contexts. Additionally, our focus on English-language studies might have led to the exclusion of relevant research in other languages, as noted by other scholars [ 20 ], potentially limiting the comprehensiveness of our analysis.…”

Does enhanced recovery after surgery programs improve clinical outcomes in liver cancer surgery?

“…As a result, these effects on inflammatory and immune response have been suggested to enable the control of tumor dissemination and potentially improve long-term outcomes in cancer. However, this benefit did not translate into improved outcomes in reported series of patients undergoing liver surgery[ 8 - 12 ].…”