Enhanced Recovery After Surgery and Perioperative Laryngectomy Outcomes.

Area of Science:

• Oncology
• Surgical Outcomes
• Health Services Research

Background:

• Laryngectomy patients face significant postoperative risks due to social, nutritional, and substance abuse factors, compounded by prior cancer treatments.
• Enhanced Recovery After Surgery (ERAS) programs are designed to mitigate surgical risks and improve patient outcomes.
• The implementation of ERAS programs in laryngectomy care warrants investigation for its impact on complications and survival.

Purpose of the Study:

• To evaluate the impact of ERAS program implementation on postoperative complication rates in laryngectomy patients.
• To assess the effect of ERAS on oncologic outcomes, including overall survival and recurrence-free survival.
• To compare the perioperative course and clinical outcomes of laryngectomy patients before and after ERAS implementation.

Main Methods:

• A historical cohort study comparing 83 patients undergoing laryngectomy (50 pre-ERAS, 33 post-ERAS) at a single institution.
• Primary outcomes included length of stay (LOS), Clavien-Dindo complications within 30 days post-discharge, overall survival (OS), and recurrence-free survival.
• Statistical analysis compared outcomes between the pre-ERAS and ERAS groups.

Main Results:

• ERAS implementation demonstrated improvements in preoperative nutritional intervention and postoperative ventilator independence.
• No significant differences were observed in severe (≥ grade 3) complications or length of stay between the ERAS and pre-ERAS groups.
• Oncologic outcomes, including overall survival and recurrence-free survival, showed no significant difference between the two groups.

Conclusions:

• ERAS programs did not significantly improve length of stay, major postoperative complications, or oncologic outcomes in this laryngectomy cohort.
• ERAS positively influenced secondary perioperative endpoints, suggesting qualitative healthcare benefits.
• Further research may be needed to optimize ERAS protocols for laryngectomy patients to achieve broader clinical improvements.