Impact of Enhanced Recovery After Surgery on Long-Term Outcomes and Postoperative Recovery in Patients Undergoing Hepatectomy: A Retrospective Cohort Study

• Main Authors: Zhang Z, Gu W, Zhang Y
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-03-01
• Series: Cancer Management and Research
• Subjects: hepatectomy; enhanced recovery after surgery; length of stay; overall survival; disease free survival
• Online Access: https://www.dovepress.com/impact-of-enhanced-recovery-after-surgery-on-long-term-outcomes-and-po-peer-reviewed-article-CMAR

Zhao Zhang,1 Weidong Gu,2 Yijing Zhang2 1Nursing Department, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of China; 2Department of Anesthesiology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, People’s Republic of ChinaCorrespondence: Yijing ZhangDepartment of Anesthesiology, Huadong Hospital Affiliated to Fudan University, No. 221 West Yan’an Road, Shanghai, 200040, People’s Republic of ChinaEmail [e-mail]: The aim of this study was to evaluate the effects of implementation of the enhanced recovery after surgery (ERAS) program on postoperative recovery and the long-term prognosis in patients who underwent hepatectomy.Methods: This retrospective study enrolled patients who underwent hepatectomy from January 2015 to December 2018 in Huadong Hospital Affiliated to Fudan University. Since June 2016, a 24-point ERAS protocol has been implemented for patients who underwent hepatic resection. The primary outcomes were overall survival (OS) and disease-free survival (DFS). The secondary outcomes included length of stay (LOS), and incidence of postoperative complications.Results: A total of 1143 patients were enrolled in this study. After propensity score matching (PSM), there was no significant difference in patients’ demographic characteristics. The DFS at 1., 3 years in ERAS group was higher than in non-ERAS group (96.3% vs 88.9% for 1 year, P=0.012; 58.9% vs 46.7% for 3 years, P=0.007). The OS at 1, 3 years in ERAS group was higher than in non-ERAS group (93.1% vs 89.3% for 1 year, P=0.041; 68.7% vs 61.2% for 3 years, P=0.035). In addition, the patients in ERAS group had lower incidences of postoperative hemorrhage, bile leak, and postoperative deep vein thrombosis/pulmonary embolism (DVT/PE), decreased 30-day readmission rate and total readmission rate, and shorter LOS.Conclusion: ERAS program could be safely applied to patients who underwent hepatectomy thereby improving their recovery and prolonging OS and DFS.Keywords: hepatectomy, enhanced recovery after surgery, length of stay, overall survival, disease-free survival