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Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy

BACKGROUND: Implementation of enhanced recovery after surgery has generally been applied to gastrointestinal surgeries; however, few studies have investigated minimally invasive McKeown esophagectomy. In this study, we aimed to evaluate the safety and feasibility of an enhanced recovery protocol aft...

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Autores principales: Tanishima, Yuichiro, Nishikawa, Katsunori, Yuda, Masami, Ishikawa, Yoshitaka, Takahashi, Keita, Tanaka, Yujiro, Matsumoto, Akira, Yano, Fumiaki, Mitsumori, Norio, Ikegami, Toru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Singapore 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891490/
https://www.ncbi.nlm.nih.gov/pubmed/33604816
http://dx.doi.org/10.1007/s10388-021-00823-3
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author Tanishima, Yuichiro
Nishikawa, Katsunori
Yuda, Masami
Ishikawa, Yoshitaka
Takahashi, Keita
Tanaka, Yujiro
Matsumoto, Akira
Yano, Fumiaki
Mitsumori, Norio
Ikegami, Toru
author_facet Tanishima, Yuichiro
Nishikawa, Katsunori
Yuda, Masami
Ishikawa, Yoshitaka
Takahashi, Keita
Tanaka, Yujiro
Matsumoto, Akira
Yano, Fumiaki
Mitsumori, Norio
Ikegami, Toru
author_sort Tanishima, Yuichiro
collection PubMed
description BACKGROUND: Implementation of enhanced recovery after surgery has generally been applied to gastrointestinal surgeries; however, few studies have investigated minimally invasive McKeown esophagectomy. In this study, we aimed to evaluate the safety and feasibility of an enhanced recovery protocol after minimally invasive McKeown esophagectomy. METHODS: Data were collected between January 2015 and April 2020 for patients who underwent esophagectomy. Of these patients, those who underwent minimally invasive McKeown esophagectomy was selected for the investigation. Perioperative outcomes and nutritional index were compared using propensity score matching between the conventional group and the enhanced recovery group. RESULTS: A total of 119 patients were enrolled in this study. Of these, 73 and 46 were treated with conventional and enhanced recovery protocol, respectively. Forty-two pairs were matched in two groups. The enhanced recovery group showed a lower rate of pulmonary complications (9.5% vs. 28.5%, p = 0.0235), abdominal dysfunctions (16.7% vs. 42.9%, p = 0.0078), and shorter hospital stay as compared with the conventional group (17.5 days vs. 23 days, p = 0.0034). The loss of body weight (6.3% vs. 7.7%, p = 0.0065) and body mass index (5.6% vs. 8.1%, p = 0.0017) were significantly lower in the enhanced recovery group than in the conventional group. In contrast, nutritional biochemistry data did not differ significantly between the two groups. CONCLUSIONS: This study shows that the promotion of an enhanced recovery protocol in minimally invasive McKeown esophagectomy maintains nutritional status without increasing postoperative complications.
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spelling pubmed-78914902021-02-19 Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy Tanishima, Yuichiro Nishikawa, Katsunori Yuda, Masami Ishikawa, Yoshitaka Takahashi, Keita Tanaka, Yujiro Matsumoto, Akira Yano, Fumiaki Mitsumori, Norio Ikegami, Toru Esophagus Original Article BACKGROUND: Implementation of enhanced recovery after surgery has generally been applied to gastrointestinal surgeries; however, few studies have investigated minimally invasive McKeown esophagectomy. In this study, we aimed to evaluate the safety and feasibility of an enhanced recovery protocol after minimally invasive McKeown esophagectomy. METHODS: Data were collected between January 2015 and April 2020 for patients who underwent esophagectomy. Of these patients, those who underwent minimally invasive McKeown esophagectomy was selected for the investigation. Perioperative outcomes and nutritional index were compared using propensity score matching between the conventional group and the enhanced recovery group. RESULTS: A total of 119 patients were enrolled in this study. Of these, 73 and 46 were treated with conventional and enhanced recovery protocol, respectively. Forty-two pairs were matched in two groups. The enhanced recovery group showed a lower rate of pulmonary complications (9.5% vs. 28.5%, p = 0.0235), abdominal dysfunctions (16.7% vs. 42.9%, p = 0.0078), and shorter hospital stay as compared with the conventional group (17.5 days vs. 23 days, p = 0.0034). The loss of body weight (6.3% vs. 7.7%, p = 0.0065) and body mass index (5.6% vs. 8.1%, p = 0.0017) were significantly lower in the enhanced recovery group than in the conventional group. In contrast, nutritional biochemistry data did not differ significantly between the two groups. CONCLUSIONS: This study shows that the promotion of an enhanced recovery protocol in minimally invasive McKeown esophagectomy maintains nutritional status without increasing postoperative complications. Springer Singapore 2021-02-18 2021 /pmc/articles/PMC7891490/ /pubmed/33604816 http://dx.doi.org/10.1007/s10388-021-00823-3 Text en © The Japan Esophageal Society 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Tanishima, Yuichiro
Nishikawa, Katsunori
Yuda, Masami
Ishikawa, Yoshitaka
Takahashi, Keita
Tanaka, Yujiro
Matsumoto, Akira
Yano, Fumiaki
Mitsumori, Norio
Ikegami, Toru
Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
title Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
title_full Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
title_fullStr Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
title_full_unstemmed Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
title_short Feasibility of enhanced recovery protocol in minimally invasive McKeown esophagectomy
title_sort feasibility of enhanced recovery protocol in minimally invasive mckeown esophagectomy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891490/
https://www.ncbi.nlm.nih.gov/pubmed/33604816
http://dx.doi.org/10.1007/s10388-021-00823-3
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