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European Archives of Oto-Rhino-Laryngology

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Open Access 08-11-2023 | Head and Neck

Enhanced recovery after surgery (ERAS) protocol improves patient outcomes in free flap surgery for head and neck cancer

Authors: Teija Nieminen, Laura Tapiovaara, Leif Bäck, Andrew Lindford, Patrik Lassus, Lasse Lehtonen, Antti Mäkitie, Harri Keski-Säntti

Published in: European Archives of Oto-Rhino-Laryngology | Issue 2/2024

Abstract

Background

In recent years, enhanced recovery after surgery (ERAS) guidelines have been developed to optimize pre-, intra-, and postoperative care of surgical oncology patients. The aim of this study was to compare management outcome of patients undergoing head and neck cancer (HNC) surgery with free flap reconstruction at our institution before and after the implementation of the ERAS guidelines.

Methods

This retrospective study comprised 283 patients undergoing HNC surgery with free flap reconstruction between 2013 and 2020. Patients operated before and after the implementation of the ERAS protocol in October 2017 formed the pre-ERAS group (n = 169), and ERAS group (n = 114), respectively.

Results

In the pre-ERAS group the mean length of stay (LOS) and intensive care unit length of the stay (ICU–LOS) were 20 days (range 7–79) and 6 days (range 1–32), and in the ERAS group 13 days (range 3–70) and 5 days (range 1–24), respectively. Both LOS (p < 0.001) and ICU–LOS (p = 0.042) were significantly reduced in the ERAS group compared to the pre-ERAS group. There were significantly fewer medical complications in the ERAS group (p < 0.003). No difference was found between the study groups in the surgical complication rate or in the 30-day or 6-month mortality rate after surgery.

Conclusions

We found reduced LOS, ICU–LOS, and medical complication rate, but no effect on the surgical complication rate after implementation of the ERAS guidelines, which supports their use in major HNC surgery.

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Title: Enhanced recovery after surgery (ERAS) protocol improves patient outcomes in free flap surgery for head and neck cancer
Authors: Teija Nieminen
Laura Tapiovaara
Leif Bäck
Andrew Lindford
Patrik Lassus
Lasse Lehtonen
Antti Mäkitie
Harri Keski-Säntti
Publication date: 08-11-2023
Publisher: Springer Berlin Heidelberg
Published in: European Archives of Oto-Rhino-Laryngology / Issue 2/2024
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08292-3

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Enhanced recovery after surgery (ERAS) protocol improves patient outcomes in free flap surgery for head and neck cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on modern management of frailty

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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