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- Title
Impact of enhanced recovery program implementation on postoperative outcomes after liver surgery: a monocentric retrospective study.
- Authors
Thierry, Gabriel; Beck, Florian; Hardy, Pierre-Yves; Kaba, Abdourahamane; Blanjean, Arielle; Vandermeulen, Morgan; Honoré, Pierre; Joris, Jean; Bonhomme, Vincent; Detry, Olivier
- Abstract
Introduction: It is still unclear whether enhanced recovery programs (ERPs) reduce postoperative morbidity after liver surgery. This study investigated the effect on liver surgery outcomes of labeling as a reference center for ERP. Materials and methods: Perioperative data from 75 consecutive patients who underwent hepatectomy in our institution after implementation and labeling of our ERP were retrospectively compared to 75 patients managed before ERP. Length of hospital stay, postoperative complications, and adherence to protocol were examined. Results: Patient demographics, comorbidities, and intraoperative data were similar in the two groups. Our ERP resulted in shorter length of stay (3 days [1–6] vs. 4 days [2–7.5], p = 0.03) and fewer postoperative complications (24% vs. 45.3%, p = 0.0067). This reduction in postoperative morbidity can be attributed exclusively to a lower rate of minor complications (Clavien-dindo grade < IIIa), and in particular to a lower rate of postoperative ileus, after labeling. (5.3% vs. 25.3%, p = 0.0019). Other medical and surgical complications were not significantly reduced. Adherence to protocol improved after labeling (17 [16–18] vs. 14 [13–16] items, p < 0.001). Conclusions: The application of a labeled enhanced recovery program for liver surgery was associated with a significant shortening of hospital stay and a halving of postoperative morbidity, mainly ileus.
- Subjects
LIVER surgery; POSTOPERATIVE care; MEDICAL protocols; HUMAN services programs; T-test (Statistics); MEDICAL quality control; EVALUATION of human services programs; FISHER exact test; LOGISTIC regression analysis; PATIENT readmissions; TREATMENT effectiveness; RETROSPECTIVE studies; DESCRIPTIVE statistics; QUANTITATIVE research; MANN Whitney U Test; CHI-squared test; MULTIVARIATE analysis; PREOPERATIVE care; ENHANCED recovery after surgery protocol; SURGICAL complications; MEDICAL records; ACQUISITION of data; STATISTICS; HOSPITAL health promotion programs; HEPATECTOMY; COMPARATIVE studies; LENGTH of stay in hospitals; DATA analysis software; QUALITY assurance; PERIOPERATIVE care; BOWEL obstructions; EVALUATION
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2024, Vol 38, Issue 6, p3253
- ISSN
1866-6817
- Publication type
Article
- DOI
10.1007/s00464-024-10796-w