Original Article


Enhanced recovery program in liver resection surgery: a single center experience

Yuan Ding, Zhenzhen Gao, Zhongquan Sun, Qiyi Zhang, Bo Zhou, Zhiwei Li, Wenyan Zhang, Yuancong Jiang, Xiangying Zhang, Guomei Ge, Matteo Ravaioli, Chris Jones, Sheng Yan, Weilin Wang, written on behalf of the AME Liver Surgery Collaborative Group

Abstract

Background: The enhanced recovery after surgery (ERAS) program promotes postoperative recovery. The study aimed to evaluate the effects of the ERAS protocol in hepatectomy.
Methods: The primary outcomes included time to first flatus and length of hospital stay (LOS). Secondary outcomes included time to first passage of stool, time to off-bed activity, pain score, abdominal distension score, postoperative liver function and complications. Outcomes were evaluated between the ERAS group (n=69) and the control group (n=232). A subanalysis of probiotics use in the ERAS group was also performed.
Results: In patients undergoing laparoscopic and open hepatectomy, time to first flatus after surgery was significantly shorter, as well as LOS, in the ERAS group. Lower incidence of post-operative complications was noted in ERAS group. While sub-analysis of probiotics group showed no significance in the primary outcomes.
Conclusions: Implementation of the ERAS protocol for hepatectomy could significantly promote postoperative recovery. Short-term application of probiotics during the perioperative period did not improve the outcomes in the ERAS group.

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