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Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer.

作者信息

Weets Victoria, Meillat Hélène, Saadoun Jacques Emmanuel, Dazza Marie, de Chaisemartin Cécile, Lelong Bernard

机构信息

Department of Digestive Surgical Oncology, Institute Paoli-Calmettes, Marseille, France.

出版信息

Ann Coloproctol. 2024 Oct;40(5):440-450. doi: 10.3393/ac.2023.00850.0121. Epub 2024 Sep 20.


DOI:10.3393/ac.2023.00850.0121
PMID:39477329
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11532380/
Abstract

PURPOSE: Enhanced Recovery After Surgery (ERAS) reduces postoperative complications (POCs) after colorectal surgery; however, its impact on the management of POCs remains unclear. This study compared the diagnosis and management of POCs before and after implementing our ERAS protocol after laparoscopic or robotic colectomy for cancer and examined the short- and mid-term oncologic impacts. METHODS: This single-center, retrospective study evaluated all consecutive patients who underwent laparoscopic or robotic colectomy for cancer between 2012 and 2021, focusing on the incidence of POCs within 90 days. We compared outcomes before (standard group) and after (ERAS group) the implementation of our ERAS protocol in January 2016. RESULTS: Significantly fewer patients in the ERAS group developed POCs (standard vs. ERAS, 136 of 380 patients [35.8%] vs.136 of 660 patients [20.6%]; P<0.01). The ERAS group had a significantly shorter mean total length of stay after POCs (13.1 days vs. 11.4 days, P=0.04), and the rates of life-threatening complications (6.7% vs. 0.7%) and 1-year mortality (7.4% vs. 1.5%) were significantly lower in the ERAS group than in the standard group. Among patients with anastomotic complications, laparoscopic reoperation was significantly more common in the ERAS group than in the standard group (8.3% vs. 75.0%, P<0.01). Among patients with postoperative ileus, the diagnosis and recovery times were significantly shorter in the ERAS group than in the standard group, resulting in a shorter total length of stay (13.5 days vs. 10 days, P<0.01). CONCLUSION: The implementation of an ERAS protocol did not eliminate all POCs, but it did accelerate their diagnosis and management and improved patient outcomes.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85ef/11532380/02a3d5b01142/ac-2023-00850-0121f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85ef/11532380/02a3d5b01142/ac-2023-00850-0121f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85ef/11532380/02a3d5b01142/ac-2023-00850-0121f1.jpg

相似文献

[1]
Impact of an Enhanced Recovery After Surgery (ERAS) program on the management of complications after laparoscopic or robotic colectomy for cancer.

Ann Coloproctol. 2024-10

[2]
Laparoscopy is not enough: full ERAS compliance is the key to improvement of short-term outcomes after colectomy for cancer.

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[3]
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[4]
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[6]
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[7]
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[9]
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[10]
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引用本文的文献

[1]
Less is more: simplifying patient-centered cancer care.

Ann Coloproctol. 2025-6

[2]
Optimizing postoperative pain management in minimally invasive colorectal surgery.

Ann Coloproctol. 2024-12

本文引用的文献

[1]
Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries - a systematic review.

World J Surg Oncol. 2021-6-29

[2]
Failure of enhanced recovery after surgery in laparoscopic colorectal surgery: a systematic review.

Int J Colorectal Dis. 2020-6

[3]
Laparoscopy is not enough: full ERAS compliance is the key to improvement of short-term outcomes after colectomy for cancer.

Surg Endosc. 2020-5

[4]
Compliance with the ERAS Protocol and 3-Year Survival After Laparoscopic Surgery for Non-metastatic Colorectal Cancer.

World J Surg. 2019-10

[5]
Postoperative intra-abdominal infection is an independent prognostic factor of disease-free survival and disease-specific survival in patients with stage II colon cancer.

Clin Transl Oncol. 2018-4-5

[6]
Proposal of a new classification of postoperative ileus based on its clinical impact-results of a global survey and preliminary evaluation in colorectal surgery.

Int J Colorectal Dis. 2017-6

[7]
Association Between the Most Frequent Complications After Surgery for Stage I-III Colon Cancer and Short-Term Survival, Long-Term Survival, and Recurrences.

Ann Surg Oncol. 2016-9

[8]
Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study.

PLoS One. 2014-12-11

[9]
Major postoperative complications following elective resection for colorectal cancer decrease long-term survival but not the time to recurrence.

Colorectal Dis. 2015-2

[10]
Laparoscopic versus open reintervention for anastomotic leakage following minimally invasive colorectal surgery.

Surg Endosc. 2015-4

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