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Enhanced recovery after hepatectomy: A systematic review
Pauline Rouxel1, Helene Beloeil1
1Department of Anaesthesiology and Critical Care Medicine, CHU de Rennes, Université de Rennes, Inserm NumeCan, CIC 1414, 35000 Rennes, France.
Anaesthesia, Critical Care & Pain Medicine
|May 29, 2018
Summary
Enhanced recovery after surgery (ERAS) programs in liver surgery are safe and effective, significantly reducing postoperative length of stay. While complication rates were lower in some studies, readmission and mortality rates remained similar to traditional care.
Area of Science:
- Hepatobiliary Surgery
- Surgical Outcomes Research
- Clinical Pathway Development
Background:
- Hepatectomy carries high postoperative complication rates.
- Enhanced Recovery After Surgery (ERAS) pathways show promise for liver surgery.
- Limited specific recommendations for ERAS in liver surgery exist.
Purpose of the Study:
- To evaluate the efficacy and safety of ERAS programs in liver surgery.
- To compare ERAS protocols against traditional care in liver resections.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) from 2007-2017.
- Included studies compared ERAS with traditional care (TC) for non-transplant liver surgeries.
- Outcomes assessed: length of stay (LoS), complications, mortality, and readmission rates.
Main Results:
- Analyzed 4 RCTs involving 524 patients (254 ERAS, 270 TC).
- ERAS significantly reduced postoperative LoS.
- Complication rates were significantly lower in ERAS in 2 of 4 studies; readmission and mortality rates were similar.
Conclusions:
- ERAS protocols are safe and effective for liver surgery.
- Further research and recommendations from scientific societies are needed to promote ERAS adoption.
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