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- Title
Perioperative fluid management influences complication rates and length of hospital stay in the enhanced recovery after surgery (ERAS) protocol for patients with colorectal cancer.
- Authors
Sato, Hiromichi; Ota, Hirofumi; Munakata, Koji; Matsuura, Yusuke; Fujii, Makoto; Wada, Noriko; Takiuchi, Daisuke; Hama, Naoki; Takachi, Kou; Yukawa, Masao
- Abstract
Purpose: To evaluate the efficacy and safety of the enhanced recovery after surgery (ERAS) protocol and quantify the impact of each ERAS item on postoperative outcomes. Methods: We used a generalized linear model to compare 289 colorectal cancer patients treated with the ERAS protocol between June, 2015 and April, 2021, with 99 colorectal cancer patients treated with the conventional colorectal surgery pathway between April, 2014 and June, 2015. Results: The median length of hospital stay (LOHS) was significantly shorter in the ERAS group, at 9 days (range 3–104 days) vs. 14 days (range 4–44 days) (p < 0.001), but the complication rates (Clavien–Dindo grade 2 or more) were similar (16.6% vs. 22.2%; p = 0.227). However, in the ERAS group, the higher the compliance with ERAS items, the lower the complication rate and LOHS (both p < 0.001). Multiple regression analysis demonstrated that "Discontinuation of continuous intravenous infusion on POD1" and "Avoidance of fluid overload" were significantly associated with the LOHS (p < 0.001 and p = 0.008). Conclusion: The ERAS protocol is safe and effective for elective colorectal cancer surgery, and compliance with the ERAS protocol contributes to shorter LOHS and fewer complications. Items related to perioperative fluid management had a crucial impact on these outcomes.
- Subjects
ENHANCED recovery after surgery protocol; LENGTH of stay in hospitals; COLORECTAL cancer; RATINGS of hospitals; CANCER patients
- Publication
Surgery Today, 2023, Vol 53, Issue 2, p242
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-022-02568-7