Is ERAS in laparoscopic surgery for colorectal cancer changing risk factors for delayed recoveryReportar como inadecuado




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Medical Oncology

, 33:25

First Online: 12 February 2016Received: 25 January 2016Accepted: 31 January 2016DOI: 10.1007-s12032-016-0738-8

Cite this article as: Pędziwiatr, M., Pisarska, M., Kisielewski, M. et al. Med Oncol 2016 33: 25. doi:10.1007-s12032-016-0738-8

Abstract

There is evidence that implementation of enhanced recovery after surgery ERAS protocols into colorectal surgery reduces complication rate and improves postoperative recovery. However, most published papers on ERAS outcomes and length of stay in hospital LOS include patients undergoing open resections. The aim of this pilot study was to determine the factors affecting recovery and LOS in patients after laparoscopic colorectal surgery for cancer combined with ERAS protocol. One hundred and forty-three consecutive patients undergoing elective laparoscopic resection were prospectively evaluated. They were divided into two subgroups depending on their reaching the targeted length of stay—LOS 75 patients in group 1—≤4 days, 68 patients in group 2—>4 days. A univariate and multivariate logistic regression analysis was performed to assess for factors demographics, perioperative parameters, complications and compliance with the ERAS protocol independently associated with LOS of 4 days or longer. The median LOS in the entire group was 4 days. The postoperative complication rate was higher 18.7 vs. 36.7 %, and the compliance with ERAS protocol was lower 91.2 vs. 76.7 % in group 2. There was an association between the pre- and postoperative compliance and the subsequent complications. In uni- and multivariate analysis, the lack of balanced fluid therapy OR 3.87, lack of early mobilization OR 20.74, prolonged urinary catheterization OR 4.58 and use of drainage OR 2.86 were significantly associated with prolonged LOS. Neither traditional patient risk factors nor the stage of the cancer was predictive of the duration of hospital stay. Instead, compliance with the ERAS protocol seems to influence recovery and LOS when applied to laparoscopic colorectal cancer surgery.

KeywordsEnhanced recovery after surgery Fast-track surgery Laparoscopy Perioperative care Compliance with protocol Colorectal cancer  Download fulltext PDF



Autor: Michał Pędziwiatr - Magdalena Pisarska - Michał Kisielewski - Maciej Matłok - Piotr Major - Mateusz Wierdak - Andrzej B

Fuente: https://link.springer.com/







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