Efficacy and safety of enhanced recovery after surgery concept combined with precise hepatectomy for the treatment of hepatocellular carcinoma

Abstract

Objective To investigate the safety and efficiency of enhanced recovery after surgery (ERAS) concept combined with precise hepatectomy (EP) in the treatment of hepatocellular carcinoma (HCC). Methods 393 HCC patients admitted to the Affiliated Provincia Hospital of Anhui Medical University were divided into group EP (n=73), precise hepatectomy group P (n=55), group ERAS (n=118) and conventional hepatectomy group C (n=147). Outcome measures were postoperative length of stay (LOS), hospital charges, postoperative complication, numerical rating scale (NRS) on postoperative 24 h, 48 h, time to ambulation and first passage of flatus, readmission rate, mortality. Results Compared to group P, patients in group EP had significantly shorter postoperative LOS(F=4.573, P<0.05), less hospital charges(F=3.090, P<0.05), lower NRS on postoperative 24 h, 48 h (F=5.235, 7.456, P<0.05), shorter time to ambulation (χ2=41.387, P<0.05) and first passage of flatus (F=0.387, P<0.05). Compared with the group ERAS, the group EP had significantly lower general postoperative complications (χ2=2.967, P<0.05). Conclusion ERAS concept combined with precise hepatectomy could optimize surgical treatment of patients with hepatocellular carcinoma. Key words: Carcinoma, hepatocellular; Hospitals, convalescent; Hepatectomy