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01-02-2012

Enhanced Recovery After Surgery (ERAS) Program Attenuates Stress and Accelerates Recovery in Patients After Radical Resection for Colorectal Cancer: A Prospective Randomized Controlled Trial

Authors: Li Ren, Dexiang Zhu, Ye Wei, Xiangou Pan, Li Liang, Jianmin Xu, Yunshi Zhong, Zhanggang Xue, Ling Jin, Shaokang Zhan, Weixin Niu, Xinyu Qin, Zhaohan Wu, Zhaoguang Wu

Published in: World Journal of Surgery | Issue 2/2012

Abstract

Background

The aim of this trial was to compare the Enhanced Recovery After Surgery (ERAS) program with conventional perioperative management in patients who underwent radical resection for colorectal cancer.

Methods

A combination of evidence-based and consensus methodology was used to develop the ERAS protocol. Five hundred ninety-seven consecutive patients who underwent elective colorectal resection were randomized to either the ERAS (n = 299) or the control group (n = 298). Outcomes relating to nutrition and metabolism index, stress index, and recovery index were measured and recorded.

Results

Demographic and operative data were similar between the two groups. Patients in the ERAS group showed improved nutritional status when compared with those of the control group. On postoperative day (POD) 1, the HOMA-IR (insulin resistance index) of the ERAS group was lower than that of the control group (p < 0.001). The cortisol level of the control group was elevated on both POD 1 (p = 0.007) and POD 5 (p = 0.002) compared to the preoperative level. However, the cortisol level of the ERAS group was not increased until POD 5 (p = 0.001). Reduced levels of TNF-α, IL-1β, IL-6, and IFN-γ in the ERAS group indicated less postoperative stress responses. In addition, ERAS was associated with accelerated recovery of gastrointestinal function. The postoperative length of stay (p < 0.001) and expense (p < 0.001) for the ERAS group were reduced in comparison to the controls. Twenty-eight cases in the control group and twenty-nine in the ERAS group suffered complications, which was not significantly different.

Conclusion

The ERAS protocol attenuates the surgical stress response and accelerates postoperative recovery without compromising patient safety.

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Title: Enhanced Recovery After Surgery (ERAS) Program Attenuates Stress and Accelerates Recovery in Patients After Radical Resection for Colorectal Cancer: A Prospective Randomized Controlled Trial
Authors: Li Ren
Dexiang Zhu
Ye Wei
Xiangou Pan
Li Liang
Jianmin Xu
Yunshi Zhong
Zhanggang Xue
Ling Jin
Shaokang Zhan
Weixin Niu
Xinyu Qin
Zhaohan Wu
Zhaoguang Wu
Publication date: 01-02-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 2/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-011-1348-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Enhanced Recovery After Surgery (ERAS) Program Attenuates Stress and Accelerates Recovery in Patients After Radical Resection for Colorectal Cancer: A Prospective Randomized Controlled Trial

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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