Enhanced recovery care versus standard care after laparoscopic liver resections:feasible and effective for liver cirrhosis? a randomized controlled trial
Enhanced recovery after surgery(ERAS)with several evidence-based elements has been shown to shorten length of hospital stay in many operations This randomized clinical trial showed that ERAS protocol is feasible and safe for laparoscopic liver resection It also reduces length of hospital stay in patients with liver cirrhosis Background Enhanced recovery after surgery(ERAS)with several evidence-based elements has been shown to shorten length of hospital stay and reduce perioperative hospital costs in many operations This randomized clinical trial was performed to compare hospital stay of laparoscopic liver resection with ERAS or with standard care Methods A randomized controlled trial was performed for laparoscopic liver resection from August 2015 to August 2016 Patients were randomly divided into ERAS group and standard care group The primary outcome was length of hospital stay(LOS)after surgery Second outcomes included hospital costs postoperative complications and 30-readmissions Elements used in ERAS group included more perioperative education nurse navigators nutrition support for liver cirrhosis respiratory therapy oral carbohydrate 2h before operation early mobilization and oral intake goal-directed fluid therapy and a better pain control Result The study included 56 patients in ERAS group and 58 patients in the standard care group Postoperative LOS was significantly shorter in the ERAS group than standard care group(5 days versus 8 days; p < 0 001)ERAS program significantly reduced the hospital costs(CHY 44303 9 versus 54451 8; p = 0 006)and complications(23 2 versus 41 4 percent; p = 0 047)Duration of first flatus and abdominal drainage were significantly reduced in ERAS group Pain control was better in ERAS(VAS POD1(≥ 4)16 1 versus 37 9 percent; p = 0 011)There was no difference in the rate of 30-days readmissions(1 8 versus 6 9 percent; p = 0 364)Patients with liver cirrhosis in ERAS group had a significantly shorter LOS compared with standard care group(5 days versus 9 days; p < 0 001)Conclusion ERAS protocol is feasible and safe for laparoscopic liver resection It also reduces length of hospital stay in patients with liver cirrhosis Patients in ERAS group have less pain and complications
Enhanced recovery after surgery (ERAS) laparoscopic liver resection randomized controlled trial length of hospital stay
Xiujun Cai Xiao Liang Hanning Ying Hongwei wang Hongxia Xu Minjun Liu Haiyan Zhou Huiqing Ge Wenbin Jiang Lijun Feng Hui Liu Yingchun Zhang Zhiying Mao Jianhua Li Bo Shen Yuelong Liang
The Department of General Surgery The Sir Run Run Shaw Hospital Medical College of Zhejiang Universi The Department of Anesthesiology The Sir Run Run Shaw Hospital Medical College of Zhejiang Universit The Department of Nursing The Sir Run Run Shaw Hospital Medical College of Zhejiang University The Department of Anesthesiology The Sir Run RunShaw Hospital Medical College of Zhejiang University The Department of Respiratory Therapy The Sir Run Run Shaw Hospital Medical College of Zhejiang Univ The Department of Clinical Nutrition The Sir Run Run Shaw Hospital Medical College of Zhejiang Unive Institution of Minimally Invasive Surgery of Zhejiang University The Department of Mental Health The Sir Run Run Shaw Hospital Medical College of Zhejiang University The Department of Physical and Rehabilitation Medicine The Sir Run Run Shaw Hospital Medical College