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Surgery Today
Published in: Surgery Today 6/2020

01-06-2020 | Nutrition | Original Article

Effects of a new perioperative enhanced recovery after surgery protocol in hepatectomy for hepatocellular carcinoma

Authors: Atsushi Fujio, Shigehito Miyagi, Kazuaki Tokodai, Wataru Nakanishi, Ryuichi Nishimura, Kazuhiro Mitsui, Michiaki Unno, Takashi Kamei

Published in: Surgery Today | Issue 6/2020

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Abstract

Purpose

Enhanced recovery after surgery (ERAS) protocols are becoming the standard of care in many surgical procedures, although data on their use following hepatectomy for hepatocellular carcinoma (HCC) are scarce. This study aimed to evaluate the effects of a new ERAS pathway in terms of the patient nutrition status after hepatectomy for HCC.

Methods

This is a retrospective analysis of 97 consecutive patients treated with open or laparoscopic hepatectomy for HCC between January 2011 and August 2014. We compared the perioperative outcomes between patients whose treatment incorporated the ERAS pathway and control patients. The nutritional status was evaluated using the controlling nutritional status score.

Results

The length of hospital stay (LOS) after both open and laparoscopic hepatectomy was shorter for the ERAS group than the control group. The days of ambulation and cessation of intravenous infusion were earlier and the postoperative nutrition status was statistically better in the ERAS group than in the control group. A multivariate analysis showed that being in the non-ERAS group was a risk factor of delayed discharge. There were no marked differences in the rate of severe complications between the two groups.

Conclusions

The ERAS pathway seems feasible and safe and results in a faster recovery, reduced LOS, improved nutrition status, and fewer severe complications.
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Metadata
Title
Effects of a new perioperative enhanced recovery after surgery protocol in hepatectomy for hepatocellular carcinoma
Authors
Atsushi Fujio
Shigehito Miyagi
Kazuaki Tokodai
Wataru Nakanishi
Ryuichi Nishimura
Kazuhiro Mitsui
Michiaki Unno
Takashi Kamei
Publication date
01-06-2020
Publisher
Springer Singapore
Published in
Surgery Today / Issue 6/2020
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01930-6

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