Fast-track surgery improves postoperative recovery in patients undergoing partial hepatectomy for primary liver cancer: A prospective randomized controlled trial

Ni, Chun-yan; Yang, Yuan; Chang, Yu‐Che; Cai, Hui; Xu, Banghao; Yang, Fei; Lau, Wan Yee; Wang, Zhi Heng; Zhou, Weiping

doi:10.1016/j.ejso.2013.03.013

Cited by 92 publications

(140 citation statements)

References 30 publications

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“…Characteristics of the four RCTs [20,21,22,23] included in our meta-analysis are presented in table 1. All studies were published between 1990 and 2014 and examined a total of 372 patients: 187 were allocated to an FT program; 185 received traditional care.…”

Section: Resultsmentioning

confidence: 99%

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Fast-Track Programs Versus Traditional Care in Hepatectomy: A Meta-Analysis of Randomized Controlled Trials

Lei

Wang²,

Tan³

et al. 2014

Dig Surg

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Background/Aims: The role of fast-track programs in hepatectomy is unclear. This meta-analysis aimed to evaluate the efficacy and safety of fast-track programs versus traditional care. Methods: We searched Pubmed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar for relevant randomized controlled trials (RCTs) comparing fast-track with traditional care in hepatectomy. Length of hospital stay, time to first flatus, postoperative complications, operating time, and intraoperative blood loss were assessed. Meta-analyses were performed using RevMan 5.2 software. Results: Four original RCTs with 372 patients were included: 187 in the fast-track and 185 in the traditional care group. Fast-track patients had shorter hospital stay (WMD -2.32; 95% CI, -3.54 to -1.11; p < 0.001) and time to first flatus (WMD -0.99; 95% CI, -1.15 to -0.84; p < 0.001), and less postoperative complications (RR 0.66; 95% CI, 0.47 to 0.93; p < 0.05). However, there was significant heterogeneity between the studies regarding hospital stay (I² = 88%; p < 0.001). Operating time and intraoperative blood loss were not different. Conclusions: Patients in fast-track programs had less time to first flatus and postoperative complications compared to traditional care. Fast-track programs may reduce the length of hospital stay. Larger, higher quality prospective RCTs are necessary to draw more robust conclusions.

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Section: Resultsmentioning

confidence: 99%

“…All four studies [20,21,22,23] (372 patients) examined this outcome measure. There was significant heterogeneity among the trials (I 2 = 88%; p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

Fast-Track Programs Versus Traditional Care in Hepatectomy: A Meta-Analysis of Randomized Controlled Trials

Lei

Wang²,

Tan³

et al. 2014

Dig Surg

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“…According to 2 recent meta-analyses, the use of ERAS protocol significantly shortened the time to first flatus, hence reducing the postoperative ileus period [12,103]. In the study by Hendry et al [89], the routine use of postoperative laxatives resulted in an earlier first passage of stool, but the overall rate of recovery was unaltered in liver surgery patients.…”

Section: Stimulation Of Bowel Movementmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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“…Due to its resistance to chemotherapy, the response and survival of patients with liver cancer remains poor (Di et al, 2012;Kudo et al, 2012;Ni et al, 2013). Recent studies focus on the potential of Traditional Chinese Medicine (TCM) in treating different kinds of cancers (Yin et al, 2011;.…”

Section: Introductionmentioning

confidence: 99%

Potential Therapeutic Efficacy of Curcumin in Liver Cancer

Dai¹,

Yin²,

Sun³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Purpose: Liver cancer, one of the most common cancers in China, is reported to feature relatively high morbidity and mortality. Curcumin (Cum) is considered as a drug possessing anti-angiogenic, anti-inflammation and anti-oxidation effect. Previous research has demonstrated antitumor effects in a series of cancers. Materials and Methods: In this study the in vitro cytotoxicity of Cum was measured by MTT assay and pro-apoptotic effects were assessed by DAPI staining and measurement of caspase-3 activity. In vivo anti-hepatoma efficacy of Cum was assessed with HepG2 xenografts. Results: It is found that Cum dose-dependently inhibited cell growth in HepG2 cells with activation of apoptosis. Moreover, Cum delayed the growth of liver cancer in a dose-dependent manner in nude mice. Conclusions: Cum might be a promising phytomedicine in cancer therapy and further efforts are needed to explore this therapeutic strategy.

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Fast-track surgery improves postoperative recovery in patients undergoing partial hepatectomy for primary liver cancer: A prospective randomized controlled trial

Cited by 92 publications

References 30 publications

Fast-Track Programs Versus Traditional Care in Hepatectomy: A Meta-Analysis of Randomized Controlled Trials

Fast-Track Programs Versus Traditional Care in Hepatectomy: A Meta-Analysis of Randomized Controlled Trials

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Potential Therapeutic Efficacy of Curcumin in Liver Cancer

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