The factors related to failure of Enhanced Recovery after Surgery (ERAS) in colon cancer surgery
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ORIGINAL ARTICLE
The factors related to failure of Enhanced Recovery after Surgery (ERAS) in colon cancer surgery Jian-Sheng Chen 1 & Si-Da Sun 1 & Zhi-Sheng Wang 1 & Tian-Hong Cai 1 & Long-Kai Huang 1 & Wen-Xing Sun 1 & Chang-Qing Lin 1 & Jun-Feng Zhou 1 & Jia-Xing Wang 1 & Qing-Liang He 1 Received: 10 May 2020 / Accepted: 23 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Enhanced Recovery after Surgery has been proven effective for patients with gastrointestinal cancer. But radical enhanced recovery could also lead to adverse clinical outcomes. Compared with reports on the estimation of successful implementation of enhanced recovery, studies on risk factors of enhanced recovery failure are still lacking. Methods A retrospective analysis was carried out on 102 patients in ERAS who underwent elective colon cancer surgery. This study included 102 patients with colon cancer between 2015 and 2019, defining enhanced recovery failure as postoperative length of stay over 10 days, stay in ICU over 24 h after surgery, reoperation, death, or unplanned readmission within 30 days after surgery. Univariate and multivariate analyses were performed to explore potential risk factors of failure. Results Aged ≥ 75, open operation, number of drainage tube over 1, re-urethral catheterization, and Clavien-Dindo grade over 2 were associated with ERAS failure, according to univariate analysis. Multivariate analysis showed that age ≥ 75 [OR 7.231; P = 0.009]; open operation (OR 3.599; P = 0.021); and number of drainage tube over 1 (OR 3.202; P = 0.020) were independent risk factors for ERAS failure. Conclusions We found age ≥ 75, open operation, and number of drainage tube over 1 are independent risk factors associated with ERAS failure after colon cancer surgery. Keywords Colon cancer . Enhanced Recovery after Surgery . Failure
Introduction Enhanced Recovery after Surgery, proposed firstly by Dr. Kehlet and his colleagues in 2001 [1], refers to a multimodal way of managing patients undergoing colorectal surgery that aims at improving perioperative quality of care [2]. The purpose of ERAS is to reduce the surgical trauma of patients in the perioperative period, reduce the stress response caused by surgery, accelerate the postoperative recovery of patients, further shorten the hospitalization time of patients, and reduce the hospitalization cost [3]. Since ERAS was put forward, an increasing number of surgeons have attached great importance to the ERAS Jian-Sheng Chen and Si-Da Sun contributed equally to this work. * Qing-Liang He [email protected] 1
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China
program [4], which has been applied in clinical practice and achieved remarkable results. Compared with conventional care, many comprehensive reviews and prospective randomized clinical trials have been published demonstrating the active effect of the ERAS program in shorter hospital stay, faster recover
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