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©The Author(s) 2015.
World J Gastroenterol. Dec 21, 2015; 21(47): 13339-13344
Published online Dec 21, 2015. doi: 10.3748/wjg.v21.i47.13339
Published online Dec 21, 2015. doi: 10.3748/wjg.v21.i47.13339
Table 1 Perioperative protocols in the enhanced recovery after surgery and conventional groups
ERAS group | Conventional group | |
PreOp | Patient education regarding FTS | Patient education |
Solid food allowed until 6 h before surgery and carbohydrate drinks until 2 h before surgery | No solid food 24 h before surgery and no liquids 12 h before surgery | |
No bowel preparation | Mechanical bowel preparation and nasogastric placement performed | |
Intraoperative | 5-trocar laparoscopy-assisted procedure. Non-opioid analgesia after induction of anesthesia. No nasogastric tube or drainage tube used. I.V. fluids were restricted (Ringer’s lactate 20 mL/kg in the first h, after that 6 mL/kg per hour). Vasoactive drugs used if needed | 5-trocar laparoscopy-assisted procedure. Routine use of abdominal drainage tubes and placement of catheters I.V. fluids not restricted (Ringer’s lactate 20 mL/kg in the first h, then at the rate of 10-12 mL/kg per hour) |
1st PostOp Day | Soluble contrast swallow study is done to check the anastomosis. If intact, fluids are started. Adequate pain control maintained | Keep NPO |
Urinary catheter removed | Removal of urinary catheter | |
Patient mobilized out of bed | Mobilization in bed | |
2nd PostOp Day | Patient started on soft food | Patient is advised to get out of bed |
Continue and increase ambulation. Pain control maintained | ||
3rd PostOp Day | Patient progresses to solid food | Remove nasogastric tube and |
Epidural stopped and acetaminophen started | Liquids started | |
Mobilization continued | Encouraged to walk in the ward | |
Drains removed | ||
4th PostOp Day | Check discharge criteria | solid food intake |
Table 2 Comparison of clinical characteristics of the patients
ERAS group | Conventional group | P value | |
(n = 30) | (n = 31) | ||
Gender (male/female) | 21/9 | 20/11 | 0.79 |
Median age (range in years) | 63 ± 12 | 62 ± 11 | 0.95 |
Tumor location | 0.94 | ||
Upper | 10 | 9 | |
Middle | 10 | 11 | |
Lower | 10 | 11 | |
Length of hospital stay (d) | 8.3 ± 1.3 | 9.9 ± 1.1 | < 0.001 |
Table 3 Comparison of surgical and oncological factors between the enhanced recovery after surgery group and the conventional group
Variables | ERAS group | Conventional group | P value |
(n = 30) | (n = 31) | ||
Type of surgery | 0.72 | ||
Distal subtotal gastrectomy D2 | 21 | 23 | |
Total gastrectomy D2 | 9 | 8 | |
TNM stage | 0.92 | ||
I | 0 | 0 | |
II | 13 | 13 | |
III | 17 | 18 | |
IV | 0 | 0 | |
Blood loss (mL) | 54.5 ± 71.8 | 64.5 ± 89.7 | 0.67 |
Operation time (min) | 137.4 ± 28.7 | 141.5 ± 30.5 | 0.74 |
Reconstruction | |||
Billroth I | 7 | 8 | 0.50 |
Billroth II | 14 | 10 | |
Roux-en-Y | 9 | 13 | |
Lymph nodes retrieved | 39.6 ± 2.3 | 41.2 ± 3.3 | 0.42 |
Table 4 Postoperative outcomes in days (d)
Variables | ERAS group | Conventional group | P value |
(n = 30) | (n = 31) | ||
Ambulation time | 2.6 ± 0.9 | 3.1 ± 1.0 | 0.04 |
Defecation time | 3.1 ± 0.7 | 3.6 ± 0.8 | 0.01 |
Food intake | 2.9 ± 0.7 | 3.5 ± 0.8 | 0.003 |
POS | 6.8 ± 1.1 | 7.7 ± 1.1 | 0.002 |
Table 5 Complications and readmission in the two groups
Variables | ERAS group | Conventional group | P value |
(n = 30) | (n = 31) | ||
Morbidity | |||
Wound infection | 0 | 1 | 1.00 |
Bleeding | 0 | 0 | - |
Ileus | 1 | 1 | 1.00 |
Stenosis | 0 | 0 | - |
Leakage | 0 | 0 | - |
Others | |||
Readmission | 0 | 0 | - |
Mortality | 0 | 0 | - |
- Citation: Abdikarim I, Cao XY, Li SZ, Zhao YQ, Taupyk Y, Wang Q. Enhanced recovery after surgery with laparoscopic radical gastrectomy for stomach carcinomas. World J Gastroenterol 2015; 21(47): 13339-13344
- URL: https://www.wjgnet.com/1007-9327/full/v21/i47/13339.htm
- DOI: https://dx.doi.org/10.3748/wjg.v21.i47.13339