Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection
| Autor: | Cornelis H. C. Dejong, P. O. Hendry, K.C.H. Fearon, Marc H.A. Bemelmans, R.M. van Dam, Marielle M.E. Coolsen, O. J. Garden, Kristoffer Lassen, Arthur Revhaug |
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| Přispěvatelé: | RS: NUTRIM - R2 - Gut-liver homeostasis, MUMC+: MA Heelkunde (9), Surgery, Algemene Heelkunde |
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Normal diet medicine.medical_treatment Patient Readmission Resection Eating Enhanced recovery Clinical Protocols Medicine Hepatectomy Humans In patient Prospective Studies Prospective cohort study Enhanced recovery after surgery Early Ambulation Aged Aged 80 and over Postoperative Care business.industry Liver Neoplasms Case-control study Recovery of Function Length of Stay Middle Aged Surgery Analgesia Epidural Case-Control Studies Female business Program Evaluation |
| Zdroj: | British Journal of Surgery, 95(8), 969-75. Wiley |
| ISSN: | 0007-1323 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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