Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Yoshikawa, Kozo, Shimada, Mitsuo, Tokunaga, Takuya, Nakao, Toshihiro, Nishi, Masaaki, Takasu, Chie, Kashihara, Hideya, Wada, Yuma, Yoshimoto, Toshiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
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
_version_ 1785042628924932096
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
work_keys_str_mv AT yoshikawakozo theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT shimadamitsuo theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT tokunagatakuya theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT nakaotoshihiro theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT nishimasaaki theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT takasuchie theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT kashiharahideya theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT wadayuma theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT yoshimototoshiaki theapplicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT yoshikawakozo applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT shimadamitsuo applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT tokunagatakuya applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT nakaotoshihiro applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT nishimasaaki applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT takasuchie applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT kashiharahideya applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT wadayuma applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis
AT yoshimototoshiaki applicationofenhancedrecoveryaftersurgeryintotalgastrectomyapropensityscorematchedanalysis