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

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Abstract

Objective

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.

Methods

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.

Results

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).

Conclusions

This study suggests that ERAS is feasible and safe for laparoscopic hepatectomy.

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Acknowledgments

The authors thank the patients who agreed to participate in the study and the surgeons, anesthetists, statistician and nurses who helped to implement the protocol.

Conflict of interest

There are no conflicts of interest.

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Authors and Affiliations

  1. Department of Hepatobiliary, Sun Yat-sen University Cancer Center, Dongfeng East Road 651, Guangzhou, 510060, Guangdong, China

    F. He, X. Lin, F. Xie, Y. Huang & R. Yuan

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  1. F. He
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  2. X. Lin
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  3. F. Xie
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Correspondence to F. He.

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He, F., Lin, X., Xie, F. et al. The effect of enhanced recovery program for patients undergoing partial laparoscopic hepatectomy of liver cancer. Clin Transl Oncol 17, 694–701 (2015). https://doi.org/10.1007/s12094-015-1296-9

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  • DOI: https://doi.org/10.1007/s12094-015-1296-9

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