Stockley Cecily, Bouchard-Fortier Antoine, Mateshaytis Jennifer, Taqi Kadhim, Mack Lloyd, Nelson Gregg, Chong Michael, Deban Melina
Department of Surgery and Oncology, University of Calgary, Calgary, Alberta, Canada.
Department of Obstetrics and Gynecology, University of Calgary, Calgary, Alberta, Canada.
J Surg Oncol. 2025 Mar;131(3):527-534. doi: 10.1002/jso.27931. Epub 2024 Oct 2.
Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) can be associated with prolonged hospital stays. A novel Enhanced Recovery After Surgery (ERAS) based on ERAS Society guidelines was designed and implemented. The primary outcome was ERAS compliance. Secondary outcomes included length of stay (LOS) and postoperative complications.
A retrospective study on patients who underwent CRS/HIPEC between 2018 and 2022, with ERAS implementation in 2022. Health records were reviewed. Statistical analysis included descriptive statistics, Wilcoxon tests, Student t-test, and χ and binomial negative regression. Health Ethics Research Board approval was obtained.
Eighty patients underwent CRS/HIPEC: 59 in the pre-ERAS group and 21 in the post-ERAS group. Groups were similar in age, comorbidities, and Peritoneal Carcinomatosis Index. ERAS compliance increased from 32.8% to 70.8% (p < 0.001). Median LOS decreased from 14 to 9 days (p < 0.001). Comparing pre-ERAS to post-ERAS showed no significant difference in the major morbidity rate (13.6% vs. 9.5%) or 30-day readmission (9.4% vs. 4.8%) and no mortalities. Controlling for patient characteristics, the mean LOS decreased by 6.94 days (p < 0.001).
Implementation of an ERAS CRS/HIPEC program is safe and allows for improved compliance to ERAS protocols and a significant reduction in LOS.
细胞减灭术联合腹腔热灌注化疗（CRS/HIPEC）可能会导致住院时间延长。基于加速康复外科（ERAS）学会指南设计并实施了一项新型加速康复外科方案。主要结局指标为ERAS依从性。次要结局指标包括住院时间（LOS）和术后并发症。
对2018年至2022年间接受CRS/HIPEC治疗的患者进行回顾性研究，2022年实施ERAS方案。查阅健康记录。统计分析包括描述性统计、Wilcoxon检验、Student t检验以及χ检验和二项式负回归。获得了健康伦理研究委员会的批准。
80例患者接受了CRS/HIPEC治疗：ERAS实施前组59例，ERAS实施后组21例。两组在年龄、合并症和腹膜癌指数方面相似。ERAS依从性从32.8%提高到70.8%（p<0.001）。中位住院时间从14天降至9天（p<0.001）。比较ERAS实施前和实施后，主要发病率（13.6%对9.5%）或30天再入院率（9.4%对4.8%）无显著差异，且无死亡病例。在控制患者特征后，平均住院时间减少了6.94天（p<0.001）。
实施ERAS CRS/HIPEC方案是安全的，可提高对ERAS方案的依从性，并显著缩短住院时间。
