The effect of enhanced recovery program for patients undergoing partial laparoscopic hepatectomy of liver cancer

• DOI: 10.1007/s12094-015-1296-9
• Publication Date: 2015-05-21T04:05:49Z
• Authors: F. He; X. Lin; F. Xie; Y. Huang; R. Yuan
• Keywords: Male; Carcinoma, Hepatocellular; Liver Neoplasms; Length of Stay; Middle Aged; Prognosis; Patient Readmission; 3. Good health; Survival Rate; 03 medical and health sciences; Postoperative Complications; 0302 clinical medicine; Elective Surgical Procedures; Quality of Life; Hepatectomy; Humans; Female; Laparoscopy; Colorectal Neoplasms; Follow-Up Studies; Neoplasm Staging

To analyze the results after the introduction of enhanced recovery after surgery (ERAS) protocols, a randomized study was performed to compare the outcomes of laparoscopic hepatectomy under ERAS or traditional care.Patients undergoing laparoscopic hepatectomy from April 2014 to October 2014 were included and randomly divided into Control group (CG) and ERAS. Primary outcome was quality of life (QoL) and length of hospital stay (LOS). Secondary endpoints were percentage readmission, mortality, duration to first flatus, complications, hospital costs, conversions and blood loss.Thirteen patients withdrew after randomization. Eighty-six patients completed the study, 48 ERAS and 38 CG. Postoperative LOS was significantly reduced in ERAS [6 (4-8) versus 10 (7-15) days, P = 0.04]. First flatus occurred earlier in ERAS than CG [2(1-4) versus 3(2-5) days, P = 0.02]. The average perioperative charges were 9470 ± 1540 in CG and only 7742 ± 1200 in ERAS (P = 0.03), with no differences in readmission rate, blood loss, conversions to open surgery, mortality or surgical complications. The median AUC (area under a curve) of QoL was considerably improved in ERAS (P = 0.04).This study suggests that ERAS is feasible and safe for laparoscopic hepatectomy.