title: Retrospective cohort study of an enhanced recovery programme in oesophageal and gastric cancer surgery.
abstract: Introduction Enhanced recovery programmes have been established in some areas of elective surgery. This study applied enhanced recovery principles to elective oesophageal and gastric cancer surgery. Methods An enhanced recovery programme for patients undergoing open oesophagogastrectomy, total and subtotal gastrectomy for oesophageal and gastric malignancy was designed. A retrospective cohort study compared length of stay on the critical care unit (CCU), total length of inpatient stay, rates of complications and in-hospital mortality prior to (35 patients) and following (27 patients) implementation. Results In the cohort study, the median total length of stay was reduced by 3 days following oesophagogastrectomy and total gastrectomy. The median length of stay on the CCU remained the same for all patients. The rates of complications and mortality were the same. Conclusions The standardised protocol reduced the median overall length of stay but did not reduce CCU stay. Enhanced recovery principles can be applied to patients undergoing major oesophagogastrectomy and total gastrectomy as long as they have minimal or reversible co-morbidity.
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: P A C
authors.initials: PA
authors.lastname: Gatenby
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: C
authors.initials: C
authors.lastname: Shaw
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: C
authors.initials: C
authors.lastname: Hine
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: S
authors.initials: S
authors.lastname: Scholtes
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: M
authors.initials: M
authors.lastname: Koutra
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: H
authors.initials: H
authors.lastname: Andrew
authors.affiliation: Royal Marsden NHS Foundation Trust , UK.
authors.forename: M
authors.initials: M
authors.lastname: Hacking
authors.forename: W H
authors.initials: WH
authors.lastname: Allum
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D017558:Elective Surgical Procedures / Q000401:mortality; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods* / Q000592:standards; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D015397:Program Evaluation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome
keywords: Enhanced recovery; Gastric neoplasms; Oesophageal neoplasms; Perioperative care; Surgical procedures