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The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis
BACKGROUND: This study aimed to investigate the feasibility and safety of our enhanced recovery after surgery protocol including early oral intake and omitting nasogastric tube (NGT) placement after total gastrectomy. METHODS: We analyzed 182 consecutive patients who underwent total gastrectomy. The...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186788/ https://www.ncbi.nlm.nih.gov/pubmed/37194033 http://dx.doi.org/10.1186/s12957-023-03034-5 |
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author | Yoshikawa, Kozo Shimada, Mitsuo Tokunaga, Takuya Nakao, Toshihiro Nishi, Masaaki Takasu, Chie Kashihara, Hideya Wada, Yuma Yoshimoto, Toshiaki |
author_facet | Yoshikawa, Kozo Shimada, Mitsuo Tokunaga, Takuya Nakao, Toshihiro Nishi, Masaaki Takasu, Chie Kashihara, Hideya Wada, Yuma Yoshimoto, Toshiaki |
author_sort | Yoshikawa, Kozo |
collection | PubMed |
description | BACKGROUND: This study aimed to investigate the feasibility and safety of our enhanced recovery after surgery protocol including early oral intake and omitting nasogastric tube (NGT) placement after total gastrectomy. METHODS: We analyzed 182 consecutive patients who underwent total gastrectomy. The clinical pathway was changed in 2015, and patients were divided into 2 groups (conventional group and modified group). Postoperative complications, bowel movement, and postoperative hospital stays were compared in the two groups in all cases and propensity score matching (PSM). RESULTS: Flatus and defecation were significantly earlier in the modified group compared with those in the conventional group (flatus: 2 (1–5) days vs 3 (2–12) days, p = 0.03; defecation: 4 (1–14) days vs 6 (2–12) days p = 0.04). The postoperative hospital stay was 18 (6–90) days in the conventional group and 14 (7–74) days in the modified group (p = 0.009). Days until discharge criteria were met were earlier in the modified group compared with that in the conventional group (10 (7–69) days vs 14 (6–84) days p = 0.01). Overall and severe complications occurred in nine patients (12.6%) and three patients (4.2%) in the conventional group and twelve patients (10.8%) and four patients (3.6%) in the modified group, respectively (p = 0.70 and p = 0.83) in all cases. In PSM, there is no significant difference between the two groups concerning the postoperative complications (overall complication 6 (12.5%) vs 8 (16.7%) p = 0.56, severe complications 1 (2%) vs 2 (4.2%) p = 0.83). CONCLUSIONS: Modified ERAS for total gastrectomy may be feasible and safe. |
format | Online Article Text |
id | pubmed-10186788 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101867882023-05-17 The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis Yoshikawa, Kozo Shimada, Mitsuo Tokunaga, Takuya Nakao, Toshihiro Nishi, Masaaki Takasu, Chie Kashihara, Hideya Wada, Yuma Yoshimoto, Toshiaki World J Surg Oncol Research BACKGROUND: This study aimed to investigate the feasibility and safety of our enhanced recovery after surgery protocol including early oral intake and omitting nasogastric tube (NGT) placement after total gastrectomy. METHODS: We analyzed 182 consecutive patients who underwent total gastrectomy. The clinical pathway was changed in 2015, and patients were divided into 2 groups (conventional group and modified group). Postoperative complications, bowel movement, and postoperative hospital stays were compared in the two groups in all cases and propensity score matching (PSM). RESULTS: Flatus and defecation were significantly earlier in the modified group compared with those in the conventional group (flatus: 2 (1–5) days vs 3 (2–12) days, p = 0.03; defecation: 4 (1–14) days vs 6 (2–12) days p = 0.04). The postoperative hospital stay was 18 (6–90) days in the conventional group and 14 (7–74) days in the modified group (p = 0.009). Days until discharge criteria were met were earlier in the modified group compared with that in the conventional group (10 (7–69) days vs 14 (6–84) days p = 0.01). Overall and severe complications occurred in nine patients (12.6%) and three patients (4.2%) in the conventional group and twelve patients (10.8%) and four patients (3.6%) in the modified group, respectively (p = 0.70 and p = 0.83) in all cases. In PSM, there is no significant difference between the two groups concerning the postoperative complications (overall complication 6 (12.5%) vs 8 (16.7%) p = 0.56, severe complications 1 (2%) vs 2 (4.2%) p = 0.83). CONCLUSIONS: Modified ERAS for total gastrectomy may be feasible and safe. BioMed Central 2023-05-16 /pmc/articles/PMC10186788/ /pubmed/37194033 http://dx.doi.org/10.1186/s12957-023-03034-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Yoshikawa, Kozo Shimada, Mitsuo Tokunaga, Takuya Nakao, Toshihiro Nishi, Masaaki Takasu, Chie Kashihara, Hideya Wada, Yuma Yoshimoto, Toshiaki The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
title | The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
title_full | The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
title_fullStr | The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
title_full_unstemmed | The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
title_short | The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
title_sort | application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186788/ https://www.ncbi.nlm.nih.gov/pubmed/37194033 http://dx.doi.org/10.1186/s12957-023-03034-5 |
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