Background: This study aims to examine if a standardized enhanced recovery program (ERP) could reduce the length of stay (LOS) after minimally invasive esophagectomy (MIO) compared to the earlier applied recovery program without increasing the risk of postoperative complications and readmissions. Methods: Retrospective study of patients with esophageal and gastroesophageal junction cancer who have had an uncomplicated postoperative stay following MIO. Patients had followed two different postoperative recovery programs according to their year of surgery (2016 versus 2018). Results: 48 patients in 2016 and 42 patients in 2018 were included. Patients were comparable on demographic factors. The median LOS was reduced from 9 days in 2016 to 8 days in 2018 (p<0.001). In 2018, 27 patients (64.3%) fulfilled the aim of discharge to their own home on day 8 after surgery. There was no significant difference (p>0.05) between the two groups in the risk of complications (Clavien-Dindo degree 0-2). Two patients in 2016 (4.2%) and two patients in 2018 (4.8%) were readmitted within 7 days after discharge (not significant). There was no in-hospital mortality or 30-day mortality in either of the two groups. Conclusion: The introduction of an ERP at our institution reduced the median postoperative stay after MIO by one day without increasing the risk of complications and readmittance. Further reduction might be obtained if oral feeding is allowed earlier.
| Published in | Journal of Surgery (Volume 9, Issue 2) |
| DOI | 10.11648/j.js.20210902.12 |
| Page(s) | 53-57 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Enhanced Postsurgical Recovery Esophagectomy, Neoplasms, Operative Surgical Procedure, Laparoscopy, Thoracoscopy
| [1] | Van der Sluis PC, Schizas D, Liakakos T et al. Minimally invasive esophagectomy. Dig Surg 2020; 37: 93-100. |
| [2] | Ainsworth AP, Larsen MH, Ladegaard L et al. Short-term outcomes after minimally invasive oesophagectomy. Dan Med J 2019; 66: A5559. |
| [3] | Elias KM. Understanding enhanced recovery after surgery guidelines: An introductory approach. J Laparoendosc Adv Surg Tech A 2017; 27: 871-5. |
| [4] | Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: A review. JAMA Surg 2017; 152: 292-8. |
| [5] | Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997; 78: 606–17. |
| [6] | Lassen K, Soop M, Nygren J et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg 2009; 144: 961-9. |
| [7] | Melloul E, Hubner M, Scott M et al. Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations. World J Surg 2016; 40: 2425-40. |
| [8] | Mortensen K, Nilsson M, Slim K et al. Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery (ERAS®) Society recommendations. Br J Surg 2014; 101: 1209-29. |
| [9] | Low DE, Allum W, Manzoni GD et al. Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS®) Society Recommendations. World J Surg 2019; 43: 299-330. |
| [10] | Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240: 205-13. |
| [11] | Gemmill EH, Humes DJ, Catton JA. Systematic review of enhanced recovery after gastro-oesophageal cancer surgery. Ann R Coll Surg Engl 2015; 97: 173-9. |
| [12] | Markar SR, Karthikesalingam A, Low DE. Enhanced recovery pathways lead to an improvement in postoperative outcomes following esophagectomy: systematic review and pooled analysis. Dis Esophagus 2015; 28: 468-75. |
| [13] | Findlay JM, Tustian E, Millo J et a. The effect of formalizing enhanced recovery after esophagectomy with a protocol. Dis Esophagus 2015; 28: 567-73. |
| [14] | Giacopuzzi S, Weindelmayer J, Treppiedi E et al. Enhanced recovery after surgery protocol in patients undergoing esophagectomy for cancer: a single center experience. Dis Esophagus 2017; 30: 1-6. |
| [15] | Berkelmans GHK, Fransen LFC, Dolmans-Zwartjes ACP et al. Direct oral feeding following minimally invasive esophagectomy (NUTRIENT II trial): An international, multicenter, open-label randomized controlled trial. Ann Surg 2020; 271: 41-7. |
APA Style
Anna Katrine Nyman Rasmussen, Michael Hareskov Larsen, Alan Patrick Ainsworth. (2021). Standardized Postoperative Recovery Reduces in-Hospital Stay After Minimally Invasive Esophagectomy. Journal of Surgery, 9(2), 53-57. https://doi.org/10.11648/j.js.20210902.12
ACS Style
Anna Katrine Nyman Rasmussen; Michael Hareskov Larsen; Alan Patrick Ainsworth. Standardized Postoperative Recovery Reduces in-Hospital Stay After Minimally Invasive Esophagectomy. J. Surg. 2021, 9(2), 53-57. doi: 10.11648/j.js.20210902.12
AMA Style
Anna Katrine Nyman Rasmussen, Michael Hareskov Larsen, Alan Patrick Ainsworth. Standardized Postoperative Recovery Reduces in-Hospital Stay After Minimally Invasive Esophagectomy. J Surg. 2021;9(2):53-57. doi: 10.11648/j.js.20210902.12
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.js.20210902.12,
author = {Anna Katrine Nyman Rasmussen and Michael Hareskov Larsen and Alan Patrick Ainsworth},
title = {Standardized Postoperative Recovery Reduces in-Hospital Stay After Minimally Invasive Esophagectomy},
journal = {Journal of Surgery},
volume = {9},
number = {2},
pages = {53-57},
doi = {10.11648/j.js.20210902.12},
url = {https://doi.org/10.11648/j.js.20210902.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20210902.12},
abstract = {Background: This study aims to examine if a standardized enhanced recovery program (ERP) could reduce the length of stay (LOS) after minimally invasive esophagectomy (MIO) compared to the earlier applied recovery program without increasing the risk of postoperative complications and readmissions. Methods: Retrospective study of patients with esophageal and gastroesophageal junction cancer who have had an uncomplicated postoperative stay following MIO. Patients had followed two different postoperative recovery programs according to their year of surgery (2016 versus 2018). Results: 48 patients in 2016 and 42 patients in 2018 were included. Patients were comparable on demographic factors. The median LOS was reduced from 9 days in 2016 to 8 days in 2018 (p0.05) between the two groups in the risk of complications (Clavien-Dindo degree 0-2). Two patients in 2016 (4.2%) and two patients in 2018 (4.8%) were readmitted within 7 days after discharge (not significant). There was no in-hospital mortality or 30-day mortality in either of the two groups. Conclusion: The introduction of an ERP at our institution reduced the median postoperative stay after MIO by one day without increasing the risk of complications and readmittance. Further reduction might be obtained if oral feeding is allowed earlier.},
year = {2021}
}
TY - JOUR T1 - Standardized Postoperative Recovery Reduces in-Hospital Stay After Minimally Invasive Esophagectomy AU - Anna Katrine Nyman Rasmussen AU - Michael Hareskov Larsen AU - Alan Patrick Ainsworth Y1 - 2021/03/12 PY - 2021 N1 - https://doi.org/10.11648/j.js.20210902.12 DO - 10.11648/j.js.20210902.12 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 53 EP - 57 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20210902.12 AB - Background: This study aims to examine if a standardized enhanced recovery program (ERP) could reduce the length of stay (LOS) after minimally invasive esophagectomy (MIO) compared to the earlier applied recovery program without increasing the risk of postoperative complications and readmissions. Methods: Retrospective study of patients with esophageal and gastroesophageal junction cancer who have had an uncomplicated postoperative stay following MIO. Patients had followed two different postoperative recovery programs according to their year of surgery (2016 versus 2018). Results: 48 patients in 2016 and 42 patients in 2018 were included. Patients were comparable on demographic factors. The median LOS was reduced from 9 days in 2016 to 8 days in 2018 (p0.05) between the two groups in the risk of complications (Clavien-Dindo degree 0-2). Two patients in 2016 (4.2%) and two patients in 2018 (4.8%) were readmitted within 7 days after discharge (not significant). There was no in-hospital mortality or 30-day mortality in either of the two groups. Conclusion: The introduction of an ERP at our institution reduced the median postoperative stay after MIO by one day without increasing the risk of complications and readmittance. Further reduction might be obtained if oral feeding is allowed earlier. VL - 9 IS - 2 ER -
Information
Email: