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Surgery Today
Published in: Surgery Today 6/2017

01-06-2017 | Original Article

Safety and efficacy of an “enhanced recovery after surgery” protocol for patients undergoing colon cancer surgery: a multi-institutional controlled study

Authors: Hirofumi Ota, Masakazu Ikenaga, Junichi Hasegawa, Kohei Murata, Yasuhiro Miyake, Tsunekazu Mizushima, Taishi Hata, Ichiro Takemasa, Hirofumi Yamamoto, Mitsugu Sekimoto, Riichiro Nezu, Yuichiro Doki, Masaki Mori

Published in: Surgery Today | Issue 6/2017

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Abstract

Purpose

The aim of this multi-institutional study was to prospectively evaluate the safety and efficacy of an enhanced recovery after surgery (ERAS) protocol for colonic surgery.

Methods

The subjects of this study were 320 patients with an American Society of Anesthesiologists (ASA) grade I or II physical status. Patients underwent elective open or laparoscopic colonic resection or high anterior resection between April 2011 and January 2014 at one of six institutions. Three hospitals implemented an ERAS protocol (n = 159), and three administered conventional care (n = 161). The primary outcome measure was the surgical complication rate.

Results

Most operations, irrespective of group, were performed laparoscopically. The incidence of a surgical complication was 17.0 % in the ERAS group vs. 16.1 % in the conventional group (P = 0.842), in which several non-surgical complications also arose. Oral food intake was implemented earlier for the ERAS group vs. the conventional group, after a median (range) of 1 (1–31) vs. 3 (1–9) days for the ERAS vs. conventional care groups, respectively (P < 0.001). The median length of postoperative hospital stay was reduced by 5.5 days for the ERAS group, being 8.5 (5–41) vs. 14 (7–56) days for the ERAS vs. conventional care groups, respectively (P < 0.001).

Conclusion

This multi-institutional controlled study clearly demonstrated that an ERAS protocol was efficient, without increasing the complication risk.
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Metadata
Title
Safety and efficacy of an “enhanced recovery after surgery” protocol for patients undergoing colon cancer surgery: a multi-institutional controlled study
Authors
Hirofumi Ota
Masakazu Ikenaga
Junichi Hasegawa
Kohei Murata
Yasuhiro Miyake
Tsunekazu Mizushima
Taishi Hata
Ichiro Takemasa
Hirofumi Yamamoto
Mitsugu Sekimoto
Riichiro Nezu
Yuichiro Doki
Masaki Mori
Publication date
01-06-2017
Publisher
Springer Japan
Published in
Surgery Today / Issue 6/2017
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-016-1423-4

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