Cargando…
Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study
BACKGROUND: Laparoscopic distal gastrectomy (LDG) has been highlighted for its safety and better short-term clinical outcomes in treating gastric cancer. However, only a slight reduction of the post-operative hospital stay was observed in gastric cancer patients undergoing LDG with conventional peri...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899858/ https://www.ncbi.nlm.nih.gov/pubmed/33607765 http://dx.doi.org/10.1097/MD.0000000000024267 |
_version_ | 1783654096613408768 |
---|---|
author | Liang, Yanrui Liu, Hao Nurse, Li Zhen Zhu, Yu Zhao, Mingli Hu, Yanfeng Yu, Jiang Li, Cai Liu, Kexuan Li, Guoxin |
author_facet | Liang, Yanrui Liu, Hao Nurse, Li Zhen Zhu, Yu Zhao, Mingli Hu, Yanfeng Yu, Jiang Li, Cai Liu, Kexuan Li, Guoxin |
author_sort | Liang, Yanrui |
collection | PubMed |
description | BACKGROUND: Laparoscopic distal gastrectomy (LDG) has been highlighted for its safety and better short-term clinical outcomes in treating gastric cancer. However, only a slight reduction of the post-operative hospital stay was observed in gastric cancer patients undergoing LDG with conventional perioperative management, compared to patients undergoing open surgery. Thus, an enhanced recovery after surgery (ERAS) program for LDG is needed to further reduce the post-operative hospital stays. This prospective, open-label, single-arm cohort study aimed to assess the safety and efficacy of the ERAS program for gastric cancer patients undergoing LDG. MATERIAL AND METHODS: All patients with gastric cancer indicated for LDG were consecutively enrolled from December 2016 to January 2018. The ERAS program included short fasting time, effective perioperative pain management, early, goal-oriented ambulation, and oral feeding. The safety assessment was the incidence of post-operative complications, mortality, and readmission in 30 days. The primary efficacy assessment was recovery time defined by post-operative hospital stays and rehabilitative rate on post-operative day 4. RESULTS: Ninety-eight of 114 patients were finally enrolled. The incidence of post-operative complication, mortality, and readmission in 30 days was 20. 4%, 0%, 7.1%, respectively. The Clavien-Dindo grade III complication rate was 6.1%, while the pulmonary complication rate was 1% only. The median post-operative stay was 6 days (5.0-7.0 days), and the rehabilitative rate on post-operative day 4 was 78%. CONCLUSIONS: The ERAS program might be optimal perioperative management for gastric cancer patients after LDG without compromising safety. TRIAL NUMBER: NCT03016026 |
format | Online Article Text |
id | pubmed-7899858 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-78998582021-02-24 Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study Liang, Yanrui Liu, Hao Nurse, Li Zhen Zhu, Yu Zhao, Mingli Hu, Yanfeng Yu, Jiang Li, Cai Liu, Kexuan Li, Guoxin Medicine (Baltimore) 4500 BACKGROUND: Laparoscopic distal gastrectomy (LDG) has been highlighted for its safety and better short-term clinical outcomes in treating gastric cancer. However, only a slight reduction of the post-operative hospital stay was observed in gastric cancer patients undergoing LDG with conventional perioperative management, compared to patients undergoing open surgery. Thus, an enhanced recovery after surgery (ERAS) program for LDG is needed to further reduce the post-operative hospital stays. This prospective, open-label, single-arm cohort study aimed to assess the safety and efficacy of the ERAS program for gastric cancer patients undergoing LDG. MATERIAL AND METHODS: All patients with gastric cancer indicated for LDG were consecutively enrolled from December 2016 to January 2018. The ERAS program included short fasting time, effective perioperative pain management, early, goal-oriented ambulation, and oral feeding. The safety assessment was the incidence of post-operative complications, mortality, and readmission in 30 days. The primary efficacy assessment was recovery time defined by post-operative hospital stays and rehabilitative rate on post-operative day 4. RESULTS: Ninety-eight of 114 patients were finally enrolled. The incidence of post-operative complication, mortality, and readmission in 30 days was 20. 4%, 0%, 7.1%, respectively. The Clavien-Dindo grade III complication rate was 6.1%, while the pulmonary complication rate was 1% only. The median post-operative stay was 6 days (5.0-7.0 days), and the rehabilitative rate on post-operative day 4 was 78%. CONCLUSIONS: The ERAS program might be optimal perioperative management for gastric cancer patients after LDG without compromising safety. TRIAL NUMBER: NCT03016026 Lippincott Williams & Wilkins 2021-02-19 /pmc/articles/PMC7899858/ /pubmed/33607765 http://dx.doi.org/10.1097/MD.0000000000024267 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) |
spellingShingle | 4500 Liang, Yanrui Liu, Hao Nurse, Li Zhen Zhu, Yu Zhao, Mingli Hu, Yanfeng Yu, Jiang Li, Cai Liu, Kexuan Li, Guoxin Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study |
title | Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study |
title_full | Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study |
title_fullStr | Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study |
title_full_unstemmed | Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study |
title_short | Enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: A prospective study |
title_sort | enhanced recovery after surgery for laparoscopic gastrectomy in gastric cancer: a prospective study |
topic | 4500 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899858/ https://www.ncbi.nlm.nih.gov/pubmed/33607765 http://dx.doi.org/10.1097/MD.0000000000024267 |
work_keys_str_mv | AT liangyanrui enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT liuhao enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT nurselizhen enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT zhuyu enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT zhaomingli enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT huyanfeng enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT yujiang enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT licai enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT liukexuan enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy AT liguoxin enhancedrecoveryaftersurgeryforlaparoscopicgastrectomyingastriccanceraprospectivestudy |