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Initial experience with a multimodal enhanced recovery programme in patients undergoing liver resection
R M van Dam1, P O Hendry, M M E Coolsen
1Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands. rvdm@surgery.azm.nl
The British Journal of Surgery
|July 12, 2008
Summary
The Enhanced Recovery After Surgery (ERAS) protocol significantly reduced hospital stays for liver resection patients. This fast-track approach is safe, enabling early oral intake and faster recovery.
Area of Science:
- Hepatobiliary surgery
- Surgical recovery protocols
- Perioperative care
Background:
- Enhanced Recovery After Surgery (ERAS) protocols optimize surgical patient recovery.
- Liver resection patients can benefit from ERAS programs.
Purpose of the Study:
- To evaluate the effectiveness of an ERAS program for patients undergoing liver resection.
- To compare outcomes between ERAS and traditional care for liver resection.
Main Methods:
- A prospective study of 61 liver resection patients managed with an ERAS protocol (epidural analgesia, early oral intake, early mobilization).
- Outcomes were compared to a historical control group of 100 patients.
Main Results:
- 92% of ERAS patients tolerated fluids within 4 hours and a normal diet on postoperative day 1.
- Median hospital stay was significantly reduced in the ERAS group (6.0 days) versus the control group (8.0 days) (P < 0.001).
- No significant differences in readmission, morbidity, or mortality rates were observed between groups.
Conclusions:
- The ERAS fast-track protocol is safe and effective for liver resection.
- ERAS facilitates early oral intake, accelerates postoperative recovery, and shortens hospital stay.