Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center

Jacopo Desiderio; Camille L. Stewart; Virginia Sun; Laleh Melstrom; Susanne Warner; Byrne Lee; Hans F. Schoellhammer; Vijay Trisal; Benjamin Paz; Yuman Fong; 우양희

doi:https://doi.org/10.5230/jgc.2018.18.e24

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자료유형: 학술저널

저자정보: Jacopo Desiderio (University of Perugia) Camille L. Stewart (City of Hope National Medical Center) Virginia Sun (City of Hope National Medical Center) Laleh Melstrom (City of Hope National Medical Center) Susanne Warner (City of Hope National Medical Center) Byrne Lee (City of Hope National Medical Center) Hans F. Schoellhammer (City of Hope National Medical Center) Vijay Trisal (City of Hope National Medical Center) Benjamin Paz (City of Hope National Medical Center) Yuman Fong (City of Hope National Medical Center) 우양희 (City of Hope National Medical Center)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제18권 제3호

발행연도: 2018.9

수록면: 230 - 241 (12page)

DOI: https://doi.org/10.5230/jgc.2018.18.e24

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Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GC-ERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015?October 1, 2016) with the historical control (HC) group (January 1, 2012?October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.

#Gastrectomy #Gastric cancer #Minimally invasive surgical procedures #Return of function

참고문헌 (29)

참고문헌 신청

Carmichael JC / 2017 / Clinical practice guideline for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons (ASCRS) and Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) / Surg Endosc 31:3412~3436

Spanjersberg WR / 2011 / Fast track surgery versus conventional recovery strategies for colorectal surgery / Cochrane Database Syst Rev 2

Mortensen K / 2014 / Consensus guidelines for enhanced recovery after gastrectomy: Enhanced Recovery After Surgery ($ERAS^{(R)}$) Society recommendations / Br J Surg 101:1209~1229

Melloul E / 2016 / Guidelines for perioperative care for liver surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations / World J Surg 40:2425~2440

Lassen K / 2012 / Guidelines for perioperative care for pancreaticoduodenectomy: Enhanced Recovery After Surgery ($ERAS^{(R)}$) Society recommendations / Clin Nutr 31:817~830

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