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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.

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