title: Usefulness of enhanced recovery after surgery protocol as compared with conventional perioperative care in gastric surgery.
abstract: BACKGROUND
  Radical gastrectomy for gastric cancer is among the most invasive procedures in gastrointestinal surgery. Several studies have found that an enhanced recovery after surgery (ERAS) protocol is useful in patients who undergo colorectal surgery, but its value in gastric surgery remains uncertain. The aim of this study was to assess the usefulness of an ERAS protocol for gastric surgery.
  
  
  METHODS
  We studied the clinical characteristics, oncological factors, surgical factors, and outcomes in patients who underwent elective radical gastrectomy for gastric cancer before and after the introduction of an ERAS protocol.
  
  
  RESULTS
  The first days of oral intake, oral intake recovery, flatus, and defecation were significantly earlier in the ERAS group (n = 91) than in the conventional care (CONV) group (n = 100). Maximum pain evaluated on a visual analog scale and the number of additional analgesics on demand were significantly less in the ERAS group than in the CONV group. The ratio of the postoperative body weight at 1 week to the preoperative body weight was significantly higher in the ERAS group than in the CONV group (0.95 vs. 0.94, respectively, P = 0.01).
  
  
  CONCLUSIONS
  Our results suggest that the ERAS protocol is useful in patients who undergo elective radical gastrectomy.
authors.affiliation: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-ku, Yokohama, Kanagawa, Japan. takay0218@yahoo.co.jp
authors.forename: Takanobu
authors.initials: T
authors.lastname: Yamada
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Hayashi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Cho
authors.forename: Takaki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Fukushima
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuburaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D001835:Body Weight; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology*; D019990:Perioperative Care / Q000379:methods*; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics