Theja Surya, Mishra Seema, Bhoriwal Sandeep, Garg Rakesh, Bharati Sachidanand Jee, Kumar Vinod, Gupta Nishkarsh, Vig Saurabh, Kumar Sunil, Deo S V S, Bhatnagar Sushma
Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India.
Department of Onco-Anaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, Room No. 249, Second Floor, New Delhi, Delhi India.
Indian J Surg Oncol. 2024 Jun;15(2):304-311. doi: 10.1007/s13193-024-01897-y. Epub 2024 Feb 12.
Enhanced Recovery After Surgery (ERAS) protocols have emerged as a promising approach to optimize perioperative care and improve outcomes in various surgical specialties. Despite feasibility studies on ERAS in various surgeries, there remains a paucity of research focusing on gastrointestinal cancer surgeries in the Indian context. The primary objective is to evaluate the compliance rate of the ERAS protocol and secondary objectives include the compliance rate of individual components of the protocol, the complications, the length of hospital stay, and the challenges faced during implementation in patients undergoing gastrointestinal cancer surgeries in our tertiary care cancer center. In this prospective interventional study (CTRI/2022/04/041657; registered on 05/04/2022), we evaluated 50 patients aged 18 to 70 years undergoing surgery for gastrointestinal malignancies and implemented a refined ERAS protocol tailored to our institutional resources and conditions based on standard ERAS society recommendations for gastrointestinal surgeries and specific recommendations for colorectal, pancreatic, and esophageal surgeries.Our study's mean overall compliance rate with the ERAS protocol was 88.54%. We achieved a compliance rate of 91.98%, 81.66%, and 92.00% for pre-operative, intraoperative, and post-operative components respectively. Fourteen (28%) patients experienced complications during the study. The median length of stay was 6.5 days (5.25-8). Challenges were encountered during the preoperative, intraoperative, and postoperative phases. The study highlighted the feasibility of implementing the ERAS protocol in a cancer institute, but specific challenges need to be addressed for its optimal success in gastrointestinal cancer surgeries.
The online version contains supplementary material available at 10.1007/s13193-024-01897-y.
术后加速康复(ERAS)方案已成为一种有前景的方法,可优化围手术期护理并改善各外科专业的治疗效果。尽管对各种手术的ERAS进行了可行性研究,但在印度背景下,针对胃肠道癌手术的研究仍然匮乏。主要目标是评估ERAS方案的依从率,次要目标包括该方案各个组成部分的依从率、并发症、住院时间以及在我们的三级癌症中心接受胃肠道癌手术的患者实施过程中面临的挑战。在这项前瞻性干预研究(CTRI/2022/04/041657;于2022年4月5日注册)中,我们评估了50例年龄在18至70岁之间接受胃肠道恶性肿瘤手术的患者,并根据ERAS协会针对胃肠道手术的标准建议以及针对结直肠癌、胰腺癌和食管癌手术的具体建议,实施了一项根据我们机构资源和条件量身定制的优化ERAS方案。我们研究中对ERAS方案的平均总体依从率为88.54%。术前、术中和术后组成部分的依从率分别为91.98%、81.66%和92.00%。14例(28%)患者在研究期间出现并发症。中位住院时间为6.5天(5.25 - 8天)。在术前、术中和术后阶段都遇到了挑战。该研究强调了在癌症研究所实施ERAS方案的可行性,但要在胃肠道癌手术中取得最佳成功,还需要应对一些特定挑战。
在线版本包含可在10.1007/s13193-024-01897-y获取的补充材料。