title: Enhanced Recovery Program Versus Traditional Care in Laparoscopic Hepatectomy.
abstract: Enhanced recovery after surgery (ERAS) has shown effectiveness in terms of reducing the hospital stay and cost associated with open liver resection. However, the benefit of ERAS in patients undergoing laparoscopic liver resection is still unclear, and clinical studies on this topic are limited.The ERAS program for laparoscopic liver resection was used in a group of 80 patients (ERAS group). The results were compared with those in a control group of 107 patients. All patients underwent laparoscopic liver resection. The primary endpoints were the postoperative hospital stay, defined as the number of days from surgery to discharge, and the hospitalization expense. The secondary endpoints were resumption of oral intake, readmissions, and complications.The median postoperative hospital stay was 6.2 ± 2.6 days in the ERAS group, which was significantly shorter than that in the control group (9.9 ± 5.9 d; P < 0.001). The hospitalization cost was $6871 ± 2571 in the ERAS group and $7948 ± 3630 in the control group (P = 0.020). The morbidity rate was 22.5% (18 of 80 patients) in the ERAS group and 43.9% (47 of 107 patients) in the control group (P = 0.002). There were no significant differences the in rate of readmission between the 2 groups.Enhanced recovery after surgery for laparoscopic liver resection is safe and effective. Patients in the ERPS group had a shorter hospital stay, fewer complications, and lower hospital costs.
authors.affiliation: From the Department of General Surgery (LX, YH, YH, CL, WY, TY, JL, LR, CX-J); Department of Anesthesiology (WH); and Department of Nursing (XH), The Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liang
authors.forename: Hanning
authors.initials: H
authors.lastname: Ying
authors.forename: Hongwei
authors.initials: H
authors.lastname: Wang
authors.forename: Hongxia
authors.initials: H
authors.lastname: Xu
authors.forename: Hong
authors.initials: H
authors.lastname: Yu
authors.forename: Liuxin
authors.initials: L
authors.lastname: Cai
authors.forename: Yifan
authors.initials: Y
authors.lastname: Wang
authors.forename: Yifan
authors.initials: Y
authors.lastname: Tong
authors.forename: Lin
authors.initials: L
authors.lastname: Ji
authors.forename: Raojun
authors.initials: R
authors.lastname: Luo
authors.forename: Xiu-Jun
authors.initials: XJ
authors.lastname: Cai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D020127:Recovery of Function; D016896:Treatment Outcome