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World Journal of Surgery
Published in: World Journal of Surgery 7/2016

01-07-2016 | Original Scientific Report

Adherence to the ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery: A Retrospective Cohort Study

Authors: Ulf O. Gustafsson, Henrik Oppelstrup, Anders Thorell, Jonas Nygren, Olle Ljungqvist

Published in: World Journal of Surgery | Issue 7/2016

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Abstract

Background

Surgical stress can influence oncological outcome and survival. The enhanced recovery after surgery (ERAS) protocol is designed to reduce perioperative stress and has been shown to reduce postoperative morbidity. We studied if adherence to ERAS is associated with increased long-term survival.

Methods

Between the years 2002 and 2007, 911 consecutive patients, operated with major colorectal cancer surgery at Ersta Hospital, Stockholm, Sweden were analyzed. The histopathological reports of the resected specimen, date, and cause of death of the patients as well as postoperative CRP levels were obtained. The relation between the rate of adherence to the ERAS protocol at the time of surgery, and the short-term outcomes in relation to 5-year overall and colorectal cancer-specific survival was determined in this retrospective cohort study.

Results

In patients with ≥70 % adherence to ERAS interventions (N = 273,), the risk of 5-year cancer-specific death was lowered by 42 %, HR 0.58 (0.39–0.88, cox regression) compared to all other patients (<70 % adherence). Significant independent perioperative predictors of increased 5-year survival were avoiding overload of intravenous fluids, HR 0.53 (0.32–0.86); oral intake on the day of operation, HR 0.55 (0.34–0.78); and low CRP levels on postoperative day 1.

Conclusion

High adherence to the ERAS protocol may be associated with improved 5-year cancer-specific survival after colorectal cancer surgery.
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Metadata
Title
Adherence to the ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery: A Retrospective Cohort Study
Authors
Ulf O. Gustafsson
Henrik Oppelstrup
Anders Thorell
Jonas Nygren
Olle Ljungqvist
Publication date
01-07-2016
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 7/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3460-y

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