Abstract
BackgroundWe aimed to evaluate postoperative recovery and short-term outcomes of patients undergoing partial hepatectomy managed with a nonstrict and individual enhanced recovery after surgery (ERAS) program.MethodsA retrospective analysis of 168 partial hepatectomy patients in our institution was included. The discharged day and the respective impact of element application throughout the duration were analyzed.ResultsWhen all the required elements of ERAS were fully implemented, the median discharge day was 6. The more deviation occurred, the more delayed the patient discharged (P < 0.01). Preoperative ASA score, basic conditions of patients and ages were revealed closely associated with discharge day (P < 0.001). Without or an early removal of tubes and early oral feeding reduced hospital stay statistically (P < 0.01). Early discharge of patients (<3 days) did not show an increased complication incidence or readmission (P > 0.05).ConclusionNonstrict and individual use of ERAS in partial hepatectomy reduced postoperative length of stay without increasing complication rate. Our study proposes a modulation of ERAS according to the needs and acceptance of patients. In a word, better optionally required rather than mandatorily meet.
Highlights
We aimed to evaluate postoperative recovery and short-term outcomes of patients undergoing partial hepatectomy managed with a nonstrict and individual enhanced recovery after surgery (ERAS) program
Partial hepatectomy is still the most common treatment for liver tumor, and there are some non-randomized studies showing that ERAS significantly reduces length of hospital stay, lowers complication rates, and cuts total costs without any increase in mortality or readmission (Schultz et al 2013; Hughes and McNally 2014)
The reality we found in clinical is that most patients could rarely often strictly meet all the elements of ERAS, while a strict ERAS requires high standards for clinical team and stringent inclusion criteria of the patients
Summary
We aimed to evaluate postoperative recovery and short-term outcomes of patients undergoing partial hepatectomy managed with a nonstrict and individual enhanced recovery after surgery (ERAS) program. ERAS refers to combining multimodal pathway including anesthesia, surgical, nursing and perioperative management to accelerate recovery, preserve body composition, and shorten discharge time without affecting morbidity. It improves efficiency of hospital beds use and a decrease of hospital cost (Kim et al 2012; Gouvas et al 2009; French et al 2009; Bosio et al 2007). To verify whether a nonstrict and individual ERAS is feasible in patients of partial hepatectomy, we have decided to take this retrospective study to compare the shortterm outcomes
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