Clinical pathway of enhanced recovery after surgery in patients undergoing hepatectomy for primary liver cancer

Abstract

Objective To investigate the safety and efficiency of practicing enhanced recovery after surgery(ERAS) concept in primary liver cancer, patients undergoing hepatectomy. Methods 90 patients with primary liver cancer were enrolled in the study. According to different methods of perioperative management, all cases were assigned into ERAS group (n=45) and control group (n=45). Outcome measures were time to functional recovery, postoperative length of stay (LOS), hospital costs, postoperative complications, numerical rating scale (NRS) scores on postoperative 24, 48 h, time to independent mobility, time to first passage of stool, readmission rate and mortality. Results Compared with control group, the ERAS group had significantly shorter time to functional recovery(t=4.003, P=0.000) and postoperative LOS (t=3.090, P=0.003), less hospital charges (t=2.281, P=0.025), lower general postoperative complication (χ2=4.286, P=0.038), lower NRS scores on postoperative 24, 48 h (t=2.851, 3.890, P=0.005, 0.000), shorter time to independent mobility (χ2=21.485, P=0.000), shorter time to first passage of stool (t=2.390, P=0.019). There were no differences in readmission rate and mortality. Conclusions ERAS was safe and efficacious, with less LOS and hospital charges and accelerated recovery for patients undergoing hepatectomy for primary liver cancer. Key words: Carcinoma, hepatocellular; Hapatectomy; Enhanced recovery after surgery