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Enhanced recovery after surgery decreases intestinal recovery time and pain intensity in patients undergoing curative gastrectomy

Authors Ji W, Chandoo A, Guo X, You T, Shao Z, Zheng K, Wang J, Bi J, Smith FG, Tucker ON, Shen X

Received 21 March 2018

Accepted for publication 9 June 2018

Published 13 September 2018 Volume 2018:10 Pages 3513—3520

DOI https://doi.org/10.2147/CMAR.S168909

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Andrew Yee

Peer reviewer comments 4

Editor who approved publication: Professor Nakshatri


Weiping Ji,1–3,* Arvine Chandoo,1,* Xiaoling Guo,1 Tao You,1 Zhuo Shao,2 Kailian Zheng,2 Juan Wang,4 Jianwei Bi,2 Fang Gao Smith,3 Olga N Tucker,5 Xian Shen1

1Department of General Surgery, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Zhejiang, People’s Republic of China; 2Department of General Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, People’s Republic of China; 3Institute of Inflammation and Dental Sciences, University of Birmingham, Birmingham, UK; 4Department of General Surgery, Xi Jing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China; 5Department of Upper Gastrointestinal Surgery, Heart of England NHS Foundation Trust, Birmingham, UK

*These authors contributed equally to this work

Background: Enhanced recovery after surgery (ERAS) reduces postoperative stress, increases patient satisfaction, and reduces postoperative stay and cost. In this study, we evaluated the feasibility and effectiveness of ERAS protocols compared with conventional perioperative care group and their effect in gastric cancer patients undergoing gastrectomy.
Methods: A cohort of 366 patients were analyzed from a prospectively maintained database. The patients’ characteristics, tumor profile, surgical information data and postoperative complications were evaluated.
Results: Patients in the ERAS had a faster gastrointestinal function recovery and first flatus (3.26±0.64; P<0.001). Pain intensity of patients in the ERAS group was significantly lower than that of patients in the conventional care group on postoperative days 1 (2.33±0.98; P<0.001) and 3 (1.06±0.63; P<0.001). Postoperative hospital stays were significantly shorter in patients receiving ERAS program (6.66±3.36; P<0.001), than in those patients who received conventional perioperative care (9.02±2.61).
Conclusion: ERAS can reduce postoperative stress, enhance the recovery of the gut, reduce the pain intensity, and increase satisfaction in gastric cancer patient undergoing curative gastrectomy.

Keywords: enhanced recovery after surgery, postoperative stress, pain intensity, postoperative complications, gastric cancer

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