Enhanced Recovery After Surgery Program for Patients Undergoing Resection of Hepatocellular Carcinoma
A recent study at our center analyzed whether an enhanced recovery after surgery (ERAS) program for patients undergoing potentially curative liver resection for hepatocellular carcinoma (HCC) influenced the feasibility, safety, and effectiveness of surgery. Clinicopathologic factors, surgical factors, and outcomes were compared in patients who underwent extended hepatectomy (resection of more than two sections) for HCC before and after the introduction of the ERAS program. Operating time and postoperative hospital stay were significantly shorter, and total volume infused during surgery significantly lower, for the ERAS than for the control group. Although retention of abdominal drainage was significantly less frequent in the ERAS group, the frequency of abdominal paracentesis in patients without intraoperative abdominal drainage was higher in this group. Oral dietary intake and ability to walk stably occurred significantly earlier in the ERAS group. Postoperative serum concentrations of albumin and cholinesterase were significantly higher in the ERAS than in the control group. These findings showed that the ERAS program for patients with mild to moderate liver dysfunction undergoing extended liver resection for HCC was feasible and effective. It allowed earlier oral dietary intake, promoted faster postoperative recovery, and reduced overall hospital stay.
KeywordsHepatectomy Liver cancer Enhanced recovery after surgery
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