Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection
- 11 July 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 95 (8), 969-975
- https://doi.org/10.1002/bjs.6227
Abstract
Background Accelerated recovery from surgery has been achieved when patients are managed within a multimodal Enhanced Recovery After Surgery (ERAS) protocol. This study evaluated the benefit of an ERAS programme for patients undergoing liver resection. Methods The ERAS protocol of epidural analgesia, early oral intake and early mobilization was studied prospectively in a consecutive series of 61 patients. Outcomes were compared with those in a consecutive series of 100 patients who underwent liver resection before the start of the study. Endpoints were postoperative length of hospital stay, postoperative resumption of oral intake, readmissions, morbidity and mortality. Results Fifty-six patients (92 per cent) in the ERAS group tolerated fluids within 4 h of surgery and a normal diet on day 1 after surgery. Median hospital stay, including readmissions, was 6·0 days compared with 8·0 days in the control group (P < 0·001). There were no significant differences in rates of readmission (13 and 10·0 per cent respectively), morbidity (41 and 31·0 per cent) and mortality (0 and 2·0 per cent) between ERAS and control groups. Conclusion The ERAS fast-track protocol is safe and effective for patients undergoing liver resection. It allows early oral intake, promotes faster postoperative recovery and reduces hospital stay.Keywords
This publication has 28 references indexed in Scilit:
- A protocol is not enough to implement an enhanced recovery programme for colorectal resectionBritish Journal of Surgery, 2007
- Randomized clinical trial of liver resection with and without hepatic pedicle clampingBritish Journal of Surgery, 2006
- A comparison in five European Centres of case mix, clinical management and outcomes following either conventional or fast-track perioperative care in colorectal surgeryClinical Nutrition, 2005
- Enhanced recovery after surgery: A consensus review of clinical care for patients undergoing colonic resectionClinical Nutrition, 2005
- Fast Tracking After Ivor Lewis EsophagogastrectomySocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2004
- National trends in the use and outcomes of hepatic resectionJournal of the American College of Surgeons, 2004
- Anaesthesia, surgery, and challenges in postoperative recoveryThe Lancet, 2003
- Improvement in Perioperative Outcome After Hepatic ResectionAnnals of Surgery, 2002
- Multimodal strategies to improve surgical outcomeThe American Journal of Surgery, 2002
- Infrarenal aortic surgery with a 3-day hospital stay: A report on success with a clinical pathwayJournal of Vascular Surgery, 1999