Cargando…
Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis
BACKGROUND: Recently, enhanced recovery after surgery (ERAS) has been widely used in the perioperative management of colorectal cancer (CRC). This study aimed to evaluate the safety and feasibility of ERAS combined with single-incision laparoscopic surgery (SILS) in CRC surgery. METHODS: This was a...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790242/ https://www.ncbi.nlm.nih.gov/pubmed/35096576 http://dx.doi.org/10.3389/fonc.2021.768299 |
_version_ | 1784639954210521088 |
---|---|
author | Wang, Changgang Feng, Haoran Zhu, Xiaoning Song, Zijia Li, You Shi, Yiqing Jiang, Yimei Chen, Xianze Zhang, Tao Zhao, Ren Liu, Kun |
author_facet | Wang, Changgang Feng, Haoran Zhu, Xiaoning Song, Zijia Li, You Shi, Yiqing Jiang, Yimei Chen, Xianze Zhang, Tao Zhao, Ren Liu, Kun |
author_sort | Wang, Changgang |
collection | PubMed |
description | BACKGROUND: Recently, enhanced recovery after surgery (ERAS) has been widely used in the perioperative management of colorectal cancer (CRC). This study aimed to evaluate the safety and feasibility of ERAS combined with single-incision laparoscopic surgery (SILS) in CRC surgery. METHODS: This was a retrospective study of patients with CRC who underwent surgery between April 2018 and April 2020 in Ruijin Hospital(North), Shanghai Jiaotong University School of Medicine. The patients were divided into three groups: group A (n=138), patients who underwent traditional multiport laparoscopic colectomy with conventional perioperative management; group B (n=63), patients who underwent SILS; and group C (n=51), patients who underwent SILS with ERAS. RESULTS: Overall, 252 participants were included in the retrospective study. The median operation time (min) in group B and group C was shorter than that in group A (group A 134.0 ± 42.5; group B 117 ± 38.9; group C 111.7 ± 35.4, p=0.004). The estimated surgical blood loss (ml) was lower in groups B and C than in group A (group A 165.1 ± 142.2; group B 122.0 ± 79.4; group C 105.2 ± 55.8, p=0.011). The length of surgical incision (cm) was shorter in groups B and C than in group A (group A 7.34 ± 1.05; group B 5.60 ± 0.80; group C 5.28 ± 0.52, p<0.001). The time before first flatus (hours) in group C was shorter than in groups A and B (group A 61.85 ± 21.14; group B 58.30 ± 20.08; group C 42.06 ± 23.72; p<0.001). The days prior to the administration of free oral fluids in group C was shorter than in groups A and B (group A 4.79 ± 1.28; group B 4.67 ± 1.11; group C 2.62 ± 0.64; p<0.001). The days of prior solid diet was less in group C than in groups A and B (group A 7.22 ± 3.87; group B 7.08 ± 3.18; group C 5.75 ± 1.70; p=0.027). The postoperative length of stay (LOS) was less in group C compared with that in groups A and B (group A 9.46 ± 4.84 days; group B 9.52 ± 7.45 days; group C 7.20 ± 2.37 days; p=0.023). The visual analog scale (VAS) scores on day 0, 1, and 2 in groups B and C were lower than those in group A (day 0, p<0.001; day 1, p<0.001; day 2, p=0.002), while the VAS score on day 3 showed no differences in the three groups (group A 1.29 ± 1.38; group B 0.98 ± 1.24; group C 0.75 ± 0.64, p=0.018). CONCLUSION: The findings suggest that SILS combined with ERAS may be a feasible and safe procedure for CRC surgery because it provides favorable cosmetic results, early dietary resumption, shorter hospital stays, and appropriate control of postoperative pain without increases in complications or readmission rates compared to conventional perioperative care with SILS or conventional laparoscopic surgery(CLS) of CRC. Further prospective randomized controlled studies are needed to enhance evidence-based medical evidence. |
format | Online Article Text |
id | pubmed-8790242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-87902422022-01-27 Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis Wang, Changgang Feng, Haoran Zhu, Xiaoning Song, Zijia Li, You Shi, Yiqing Jiang, Yimei Chen, Xianze Zhang, Tao Zhao, Ren Liu, Kun Front Oncol Oncology BACKGROUND: Recently, enhanced recovery after surgery (ERAS) has been widely used in the perioperative management of colorectal cancer (CRC). This study aimed to evaluate the safety and feasibility of ERAS combined with single-incision laparoscopic surgery (SILS) in CRC surgery. METHODS: This was a retrospective study of patients with CRC who underwent surgery between April 2018 and April 2020 in Ruijin Hospital(North), Shanghai Jiaotong University School of Medicine. The patients were divided into three groups: group A (n=138), patients who underwent traditional multiport laparoscopic colectomy with conventional perioperative management; group B (n=63), patients who underwent SILS; and group C (n=51), patients who underwent SILS with ERAS. RESULTS: Overall, 252 participants were included in the retrospective study. The median operation time (min) in group B and group C was shorter than that in group A (group A 134.0 ± 42.5; group B 117 ± 38.9; group C 111.7 ± 35.4, p=0.004). The estimated surgical blood loss (ml) was lower in groups B and C than in group A (group A 165.1 ± 142.2; group B 122.0 ± 79.4; group C 105.2 ± 55.8, p=0.011). The length of surgical incision (cm) was shorter in groups B and C than in group A (group A 7.34 ± 1.05; group B 5.60 ± 0.80; group C 5.28 ± 0.52, p<0.001). The time before first flatus (hours) in group C was shorter than in groups A and B (group A 61.85 ± 21.14; group B 58.30 ± 20.08; group C 42.06 ± 23.72; p<0.001). The days prior to the administration of free oral fluids in group C was shorter than in groups A and B (group A 4.79 ± 1.28; group B 4.67 ± 1.11; group C 2.62 ± 0.64; p<0.001). The days of prior solid diet was less in group C than in groups A and B (group A 7.22 ± 3.87; group B 7.08 ± 3.18; group C 5.75 ± 1.70; p=0.027). The postoperative length of stay (LOS) was less in group C compared with that in groups A and B (group A 9.46 ± 4.84 days; group B 9.52 ± 7.45 days; group C 7.20 ± 2.37 days; p=0.023). The visual analog scale (VAS) scores on day 0, 1, and 2 in groups B and C were lower than those in group A (day 0, p<0.001; day 1, p<0.001; day 2, p=0.002), while the VAS score on day 3 showed no differences in the three groups (group A 1.29 ± 1.38; group B 0.98 ± 1.24; group C 0.75 ± 0.64, p=0.018). CONCLUSION: The findings suggest that SILS combined with ERAS may be a feasible and safe procedure for CRC surgery because it provides favorable cosmetic results, early dietary resumption, shorter hospital stays, and appropriate control of postoperative pain without increases in complications or readmission rates compared to conventional perioperative care with SILS or conventional laparoscopic surgery(CLS) of CRC. Further prospective randomized controlled studies are needed to enhance evidence-based medical evidence. Frontiers Media S.A. 2022-01-12 /pmc/articles/PMC8790242/ /pubmed/35096576 http://dx.doi.org/10.3389/fonc.2021.768299 Text en Copyright © 2022 Wang, Feng, Zhu, Song, Li, Shi, Jiang, Chen, Zhang, Zhao and Liu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Wang, Changgang Feng, Haoran Zhu, Xiaoning Song, Zijia Li, You Shi, Yiqing Jiang, Yimei Chen, Xianze Zhang, Tao Zhao, Ren Liu, Kun Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis |
title | Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis |
title_full | Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis |
title_fullStr | Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis |
title_full_unstemmed | Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis |
title_short | Comparative Effectiveness of Enhanced Recovery After Surgery Program Combined With Single-Incision Laparoscopic Surgery in Colorectal Cancer Surgery: A Retrospective Analysis |
title_sort | comparative effectiveness of enhanced recovery after surgery program combined with single-incision laparoscopic surgery in colorectal cancer surgery: a retrospective analysis |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790242/ https://www.ncbi.nlm.nih.gov/pubmed/35096576 http://dx.doi.org/10.3389/fonc.2021.768299 |
work_keys_str_mv | AT wangchanggang comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT fenghaoran comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT zhuxiaoning comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT songzijia comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT liyou comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT shiyiqing comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT jiangyimei comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT chenxianze comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT zhangtao comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT zhaoren comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis AT liukun comparativeeffectivenessofenhancedrecoveryaftersurgeryprogramcombinedwithsingleincisionlaparoscopicsurgeryincolorectalcancersurgeryaretrospectiveanalysis |