Enhanced Recovery after Surgery (ERAS) Program for Patients with Peritoneal Surface Malignancies Undergoing...

Area of Science:

• Oncology
• Surgical Innovation
• Evidence-Based Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) programs are multimodal interventions proven to shorten hospital stays and decrease complications in various major surgeries.
• The efficacy and safety of ERAS protocols for peritoneal surface malignancies, particularly after cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC), remain under investigation.

Purpose of the Study:

• To systematically review and meta-analyze the impact of ERAS on outcomes following CRS with or without HIPEC for peritoneal metastases.
• To evaluate the safety and efficacy of ERAS in managing peritoneal cancer patients.

Main Methods:

• A systematic review and meta-analysis were conducted, searching databases including MEDLINE, PubMed, EMBASE, Google Scholar, and Cochrane from January 2010 to December 2021.
• Included studies were single and double-cohort studies focusing on ERAS application in peritoneal cancer treatment.
• Key outcomes assessed were postoperative length of stay (LOS), morbidity, mortality, and early readmission rates.

Main Results:

• Twenty-four studies involving 5131 patients were analyzed, with 7 on ERAS in CRS + HIPEC and 17 on CRS alone.
• ERAS implementation significantly reduced LOS in both CRS + HIPEC (-3.17 days) and CRS alone (-1.65 days) groups.
• A notable reduction in postoperative morbidity was observed with ERAS protocols.

Conclusions:

• Implementing ERAS protocols can lead to reduced length of stay and fewer postoperative complications after cytoreductive surgery, with or without HIPEC.
• ERAS represents a valuable approach for optimizing patient recovery in the context of peritoneal surface malignancies.