Enhanced recovery after surgery program in the patients undergoing hepatectomy for benign liver lesions.
Bilirubin
/ blood
Blood Loss, Surgical
Blood Transfusion
Enhanced Recovery After Surgery
Female
Fibrin Fibrinogen Degradation Products
/ metabolism
Hepatectomy
/ adverse effects
Humans
Laparoscopy
/ adverse effects
Length of Stay
Liver Diseases
/ surgery
Male
Middle Aged
Operative Time
Postoperative Complications
/ etiology
Retrospective Studies
Benign liver lesions
Enhanced recovery after surgery
Hepatectomy
Laparoscopy
Liver function
Journal
Hepatobiliary & pancreatic diseases international : HBPD INT
ISSN: 1499-3872
Titre abrégé: Hepatobiliary Pancreat Dis Int
Pays: Singapore
ID NLM: 101151457
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
15
09
2019
accepted:
31
12
2019
pubmed:
28
1
2020
medline:
11
3
2021
entrez:
28
1
2020
Statut:
ppublish
Résumé
Enhanced recovery after surgery (ERAS) has shown effectiveness in terms of reducing the hospital stay and cost. However, the benefit of ERAS in patients undergoing hepatectomy for benign liver lesions is still unclear. ERAS was implemented in our center since March 1st, 2018. From September 2016 to February 2018, 109 patients were enrolled into the control group, and from March 2018 to June 2019, 124 patients were enrolled into the ERAS group. All the indicators related to operation, liver functions, and postoperative outcomes were included in the analysis. The clinicopathologic baselines were similar in these two groups. A significantly higher proportion of patients underwent laparoscopic surgery in the ERAS group. On the whole, intraoperative blood loss (100.00 mL vs. 200.00 mL, P < 0.001), blood transfusion (3.23% vs. 10.09%, P = 0.033), total bilirubin (17.10 µmol/L vs. 21.00 µmol/L, P = 0.041), D-dimer (2.08 µg/mL vs. 2.57 µg/mL, P = 0.031), postoperative hospital stay (5.00 d vs. 6.00 d, P < 0.001), and postoperative morbidity (16.13% vs. 32.11%, P = 0.008) were significantly shorter or less in the ERAS group than those in the control group. After stratified by operation methods, ERAS group showed significantly shorter postoperative hospital stay in both open and laparoscopic operation (both P < 0.001). In patients underwent open surgery, ERAS group demonstrated significantly shorter operative duration (131.76 ± 8.75 min vs. 160.73 ± 7.23 min, P = 0.016), less intraoperative blood loss (200.00 mL vs. 450.00 mL, P = 0.008) and less postoperative morbidity (16.00% vs. 44.44%, P = 0.040). ERAS program may be safe and effective for the patients underwent hepatectomy, especially open surgery, for benign liver lesions.
Sections du résumé
BACKGROUND
BACKGROUND
Enhanced recovery after surgery (ERAS) has shown effectiveness in terms of reducing the hospital stay and cost. However, the benefit of ERAS in patients undergoing hepatectomy for benign liver lesions is still unclear.
METHODS
METHODS
ERAS was implemented in our center since March 1st, 2018. From September 2016 to February 2018, 109 patients were enrolled into the control group, and from March 2018 to June 2019, 124 patients were enrolled into the ERAS group. All the indicators related to operation, liver functions, and postoperative outcomes were included in the analysis.
RESULTS
RESULTS
The clinicopathologic baselines were similar in these two groups. A significantly higher proportion of patients underwent laparoscopic surgery in the ERAS group. On the whole, intraoperative blood loss (100.00 mL vs. 200.00 mL, P < 0.001), blood transfusion (3.23% vs. 10.09%, P = 0.033), total bilirubin (17.10 µmol/L vs. 21.00 µmol/L, P = 0.041), D-dimer (2.08 µg/mL vs. 2.57 µg/mL, P = 0.031), postoperative hospital stay (5.00 d vs. 6.00 d, P < 0.001), and postoperative morbidity (16.13% vs. 32.11%, P = 0.008) were significantly shorter or less in the ERAS group than those in the control group. After stratified by operation methods, ERAS group showed significantly shorter postoperative hospital stay in both open and laparoscopic operation (both P < 0.001). In patients underwent open surgery, ERAS group demonstrated significantly shorter operative duration (131.76 ± 8.75 min vs. 160.73 ± 7.23 min, P = 0.016), less intraoperative blood loss (200.00 mL vs. 450.00 mL, P = 0.008) and less postoperative morbidity (16.00% vs. 44.44%, P = 0.040).
CONCLUSIONS
CONCLUSIONS
ERAS program may be safe and effective for the patients underwent hepatectomy, especially open surgery, for benign liver lesions.
Identifiants
pubmed: 31983674
pii: S1499-3872(20)30007-2
doi: 10.1016/j.hbpd.2019.12.012
pii:
doi:
Substances chimiques
Fibrin Fibrinogen Degradation Products
0
fibrin fragment D
0
Bilirubin
RFM9X3LJ49
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
122-128Informations de copyright
Copyright © 2020. Published by Elsevier B.V.