Influence of the Enhanced Recovery After Surgery Protocol on Postoperative Inflammation and Short-term Postoperative Surgical Outcomes After Colorectal Cancer Surgery
| Autor: | Bong-Hyeon Kye, Heba Essam Jaloun, Na Young Sung, Suhail Abdullah Al Turkistani, Hae Myung Jeon, Dae Youn Won, Sun Min Park, Sang Hyun Hong, In Kyu Lee, Min Ki Kim, Yoon Suk Lee |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Lymphocyte Gastroenterology Inflammation RC799-869 Diseases of the digestive system. Gastroenterology Colorectal neoplasms Surgery medicine.anatomical_structure White blood cell Colorectal cancer surgery medicine In patient Original Article Laparoscopy Inflammation Length of stay medicine.symptom Postoperative inflammation business Enhanced recovery after surgery |
| Zdroj: | Annals of Coloproctology Annals of Coloproctology, Vol 36, Iss 4, Pp 264-272 (2020) |
| ISSN: | 2287-9722 2287-9714 |
| Popis: | Purpose: Many studies have shown that the enhanced recovery after surgery (ERAS) protocols improve postoperative surgical outcomes. The purpose of this study was to observe the effects on postoperative inflammatory markers and to explore the effects of a high degree of compliance and the use of epidural anesthesia on inflammation and surgical outcomes.Methods: Four hundred patients underwent colorectal cancer surgery at 2 hospitals during 2 different periods, namely, from January 2006 to December 2009 and from January 2017 to July 2017. Data related to the patient’s clinicopathological features, inflammatory markers, percentage of compliance with elements of the ERAS protocol, and use of epidural anesthesia were collected from a prospectively maintained database.Results: The complication rate and the length of hospital stay (LOS) were less in the ERAS group than in the conventional group (P = 0.005 and P ≤ 0.001, respectively). The postoperative white blood cell count and the duration required for leukocytes to normalize were reduced in patients following the ERAS protocol (P ≤ 0.001). Other inflammatory markers, such as lymphocyte count (P = 0.008), neutrophil/lymphocyte ratio (P = 0.032), and C-reactive protein level (P ≤ 0.001), were lower in the ERAS protocol group. High compliance ( ≥ 70%) was strongly associated with the complication rate and the LOS (P = 0.008 and P ≤ 0.001, respectively).Conclusion: ERAS protocols decrease early postoperative inflammation and improves short-term postoperative recovery outcomes such as complication rate and the LOS. High compliance ( ≥ 70%) with the ERAS protocol elements accelerates the positive effects of ERAS on surgical outcomes; however, the effect on inflammation was very small. |
| Databáze: | OpenAIRE |
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