Laparoscopic Gastrectomy with Enhanced Recovery After Surgery Protocol: Single-Center Experience.
BACKGROUND Surgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol. MATERIAL AND METHODS Fifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed. Demographic and surgical parameters were assessed, as well as the compliance with ERAS protocol elements, length of hospital stay, number of complications, and readmissions. RESULTS Mean operative time was 296.4±98.9 min, and mean blood loss was 293.3±213.8 mL. In 3 (5.7%) cases, conversion was required. Median length of hospital stay was 5 days. Compliance with ERAS protocol was 79.6±14.5%. Thirty (56.6%) patients tolerated an early oral diet well within 24 h postoperatively; in 48 (90.6%) patients, mobilization in the first 24 hours was successful. In 17 (32.1%) patients, postoperative complications occurred, with 7 of them (13.2%) being serious (Clavien-Dindo 3-5). The 30-day readmission rate was 9.4%. CONCLUSIONS The combination of laparoscopy and the ERAS protocol in patients with gastric cancer is feasible and allows achieving good clinical outcomes.
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Magdalena
M
Pisarska
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Michał
M
Pędziwiatr
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Piotr
P
Major
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Michał
M
Kisielewski
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Marcin
M
Migaczewski
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Mateusz
M
Rubinkiewicz
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Piotr
P
Budzyński
Jagiellonian University Medical College, 2nd Department of General Surgery, Cracow, Poland.
Krzysztof
K
Przęczek
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Anna
A
Zub-Pokrowiecka
2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland.
Andrzej
A
Budzyński
D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology; D011184:Postoperative Period; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*