Cargando…
Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol
Enhanced recovery after surgery (ERAS) is established for autologous breast reconstruction. ERAS leads to a shortened hospital stay and improved outcome after elective surgery. In this retrospective, two-center case–control study, we compared two different treatment regimens for patients undergoing...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954560/ https://www.ncbi.nlm.nih.gov/pubmed/35330347 http://dx.doi.org/10.3390/jpm12030347 |
_version_ | 1784676123688304640 |
---|---|
author | Linder, Sora Walle, Leonard Loucas, Marios Loucas, Rafael Frerichs, Onno Fansa, Hisham |
author_facet | Linder, Sora Walle, Leonard Loucas, Marios Loucas, Rafael Frerichs, Onno Fansa, Hisham |
author_sort | Linder, Sora |
collection | PubMed |
description | Enhanced recovery after surgery (ERAS) is established for autologous breast reconstruction. ERAS leads to a shortened hospital stay and improved outcome after elective surgery. In this retrospective, two-center case–control study, we compared two different treatment regimens for patients undergoing a DIEP-flap breast reconstruction from two centers, one with an established ERAS protocol and one without. All patients with DIEP breast reconstructions over the period of 12 months were included. The primary outcome measure was the length of hospital stay (LOS) in days. A total of 79 patients with 95 DIEP-flaps were analyzed. In group A (ERAS) 42 patients were operated with DIEP flaps, in group B (non-ERAS) 37 patients. LOS was significantly reduced in the ERAS group (4.51 days) compared to the non-ERAS group (6.32; p < 0.001). Multivariate analysis showed that, in group A, LOS is significantly affected by surgery duration. BMI in the ERAS group had no effect on LOS. In group B a higher BMI resulted in a significantly higher LOS. In multivariate analysis, neither age nor type for surgery (primary/secondary/after neoadjuvant therapy, etc.) affected LOS. In both groups, no systemic or flap-related complications were observed. Comparing two reconstructive centers with and without implemented ERAS, ERAS led to a significantly decreased LOS for all patients. ERAS implementation does not result in an increased complication rate or flap loss. Postoperative pain can be well managed with basic analgesia using NSAID when intraoperative blocks are applied. The reduced use of opioids was well tolerated. With implementation of ERAS the recovery experience can be enhanced making autologous breast reconstructions more available and attractive for various patients. |
format | Online Article Text |
id | pubmed-8954560 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89545602022-03-26 Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol Linder, Sora Walle, Leonard Loucas, Marios Loucas, Rafael Frerichs, Onno Fansa, Hisham J Pers Med Article Enhanced recovery after surgery (ERAS) is established for autologous breast reconstruction. ERAS leads to a shortened hospital stay and improved outcome after elective surgery. In this retrospective, two-center case–control study, we compared two different treatment regimens for patients undergoing a DIEP-flap breast reconstruction from two centers, one with an established ERAS protocol and one without. All patients with DIEP breast reconstructions over the period of 12 months were included. The primary outcome measure was the length of hospital stay (LOS) in days. A total of 79 patients with 95 DIEP-flaps were analyzed. In group A (ERAS) 42 patients were operated with DIEP flaps, in group B (non-ERAS) 37 patients. LOS was significantly reduced in the ERAS group (4.51 days) compared to the non-ERAS group (6.32; p < 0.001). Multivariate analysis showed that, in group A, LOS is significantly affected by surgery duration. BMI in the ERAS group had no effect on LOS. In group B a higher BMI resulted in a significantly higher LOS. In multivariate analysis, neither age nor type for surgery (primary/secondary/after neoadjuvant therapy, etc.) affected LOS. In both groups, no systemic or flap-related complications were observed. Comparing two reconstructive centers with and without implemented ERAS, ERAS led to a significantly decreased LOS for all patients. ERAS implementation does not result in an increased complication rate or flap loss. Postoperative pain can be well managed with basic analgesia using NSAID when intraoperative blocks are applied. The reduced use of opioids was well tolerated. With implementation of ERAS the recovery experience can be enhanced making autologous breast reconstructions more available and attractive for various patients. MDPI 2022-02-25 /pmc/articles/PMC8954560/ /pubmed/35330347 http://dx.doi.org/10.3390/jpm12030347 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Linder, Sora Walle, Leonard Loucas, Marios Loucas, Rafael Frerichs, Onno Fansa, Hisham Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol |
title | Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol |
title_full | Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol |
title_fullStr | Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol |
title_full_unstemmed | Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol |
title_short | Enhanced Recovery after Surgery (ERAS) in DIEP-Flap Breast Reconstructions—A Comparison of Two Reconstructive Centers with and without ERAS-Protocol |
title_sort | enhanced recovery after surgery (eras) in diep-flap breast reconstructions—a comparison of two reconstructive centers with and without eras-protocol |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8954560/ https://www.ncbi.nlm.nih.gov/pubmed/35330347 http://dx.doi.org/10.3390/jpm12030347 |
work_keys_str_mv | AT lindersora enhancedrecoveryaftersurgeryerasindiepflapbreastreconstructionsacomparisonoftworeconstructivecenterswithandwithouterasprotocol AT walleleonard enhancedrecoveryaftersurgeryerasindiepflapbreastreconstructionsacomparisonoftworeconstructivecenterswithandwithouterasprotocol AT loucasmarios enhancedrecoveryaftersurgeryerasindiepflapbreastreconstructionsacomparisonoftworeconstructivecenterswithandwithouterasprotocol AT loucasrafael enhancedrecoveryaftersurgeryerasindiepflapbreastreconstructionsacomparisonoftworeconstructivecenterswithandwithouterasprotocol AT frerichsonno enhancedrecoveryaftersurgeryerasindiepflapbreastreconstructionsacomparisonoftworeconstructivecenterswithandwithouterasprotocol AT fansahisham enhancedrecoveryaftersurgeryerasindiepflapbreastreconstructionsacomparisonoftworeconstructivecenterswithandwithouterasprotocol |