Feasibility of a Clinical Pathway With Early Oral Intake and Discharge for Laparoscopic Gastrectomy

Nakagawa, Masatoshi; Tomii, Chiharu; Inokuchi, Mikito; Otsuki, Sho; Kojima, Kazuyuki

doi:10.1177/1457496917748228

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Based the original work of Kehlet and Wilmore [6], the ERAS protocol has been widely accepted and applied in the clinic. Our center have finished a trial to probe the application of ERAS in These authors contributed equally: Dan Liu, Xinxin Jing perioperative gastrectomy [7] and we found that early intake of liquid and food after surgery can facilitate postoperative restoration without increasing the incidence of fistulas, consistent with other studies [8][9][10][11]. However, it is controversial what kind of food or liquid should be the standard of early intake.…”

Section: Introductionsupporting

confidence: 84%

“…Randomization was performed using PASS 11.0 software to generate random numbers and divide patients into two group evenly, using opaque sealed sequentially numbered envelopes that were opened at the moment of surgery completion. Previous our studies on postoperative ileus after gastrectomy showed a mean time to the first bowel movement of 110 ± 25.7 h (mean ± standard deviation) for control patients [8]. To detect a clinically relevant absolute difference of 24 h in time to the first bowel movement with a two-sided significance level of 0•05 and a power of 90%, it was calculated that 26 patients per study arm would be required.…”

Section: Sample Size Randomization and Statisticsmentioning

confidence: 99%

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Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial

et al. 2021

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Background Early intake after surgery can decrease postoperative ileus. Several studies show coffee can stimulate bowel activity and be safe in patients after elective colectomy, mainly due to caffeine. It was postulated that drinking Chinese green tea as rich caffeine beverage after subtotal distal gastrectomy accelerates postoperative recovery in patients. Method This was a single-centre parallel open-label randomized trial. Patients with gastric cancer undergoing robotic or laparoscopic subtotal gastrectomy were randomly allocated to receive drinking Chinese green tea (GT group) or potable water (PW group) after surgery. The primary endpoint was the time to gastrointestinal function recovery and tolerance of solid food, and the secondary endpoints included the incidence of postoperative complications, symptoms of postoperative adverse reaction, length of stay, pain as assessed by analgesic consumption and a visual analogue scale, and fatigue as assessed by a fatigue score model. Results A total of 80 patients were recruited, 40 to each group. Patient characteristics were similar in both groups. The GT group showed significantly shorter time to gastrointestinal function recovery compared with PW group to first flatus (47.23 ± 13.46 vs. 76.96 ± 20.35, P < 0.001), first bowel motion (78.70 ± 25.77 vs. 125.76 ± 36.25, P < 0.001) and tolerance of solid food (62.20 ± 16.15 vs. 98.66 ± 20.15, P < 0.001). Conclusion Drinking Chinese green tea after robotic or laparoscopic subtotal gastrectomy is safe and promotes postoperative recovery of gastrointestinal function, also was an add method with strengthening analgesia and anti-inflammatory effect in the presence of the Enhance Recovery After Surgery (ERAS) program. Registration number: ChiCTR1800018294 (http://www.chictr.org.cn).

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Section: Introductionsupporting

confidence: 84%

Section: Sample Size Randomization and Statisticsmentioning

confidence: 99%

Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial

et al. 2021

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“…Our study assessed concurrent morbidities using ASA score, which is believed to affect recovery from abdominal surgery. In a clinical pathway program for gastrectomy, Nakagawa and colleagues reported ASA and postoperative morbidity were the risk factors for discharge variance [ 17 ]. Since ASA scores were significantly different between groups in our data, we performed the PSM process to reduce bias.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Clinical Pathway for Hepatic Cystic Echinococcosis Surgery in Kashi Prefecture, Northwestern China: A Propensity Score Matching Analysis

Ibrahim

Yasheng

Tuerxun³

et al. 2021

Infect Dis Ther

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Introduction Surgical treatment for hepatic cystic ehinococcosis (CE) is not standardized in Kashi Prefecture. Previous evidence identified effectiveness of a clinical pathway in the field of liver surgery. However, proof of a clinical pathway program, especially for CE patients, is lacking. This study aimed to assess the validity of a clinical pathway for hepatic CE surgery performed on patients from Kashi Prefecture. Methods A clinical pathway was developed and implemented by a multidisciplinary team for patients undergoing hepatic CE surgery. Two groups were formed from patients undergoing hepatic CE surgery during a defined period before and after implementing a clinical pathway. Additionally, a propensity score matching analysis was performed. Results In the overall analysis ( n = 258) as well as the matched analysis ( n = 166), after implementing the clinical pathway, hospital stay was significantly reduced from 13 to 10 days and from 14 to 10 days, respectively ( P < 0.05). Postoperative morbidity did not increase. Cost analysis showed a significant decrease in median costs of medication and nursing in favor of the clinical pathway (medication: 5400 CNY vs. 6400 CNY, P = 0.038; nursing: 3200 CNY vs. 4100 CNY, P = 0.02). Conclusion Implementing the clinical pathway for hepatic CE surgery is feasible and safe. The clinical pathway achieved significant reduction of hospital stay without compromising postoperative morbidity. Costs of medication and nursing are significantly reduced. The clinical pathway program is valid and propagable to a certain extent, especially in remote, poor-resourced medical centers in endemic areas.

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Feasibility and Safety of Early Oral Intake and Discharge After Total or Proximal Gastrectomy: An Analysis of Consecutive Cases Without Exclusion Criteria

et al. 2019

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Feasibility of a Clinical Pathway With Early Oral Intake and Discharge for Laparoscopic Gastrectomy

Cited by 3 publications

References 33 publications

Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial

Impact of drinking Chinese green tea on postoperative short outcomes for gastric cancer: a randomized controlled trial

Effectiveness of a Clinical Pathway for Hepatic Cystic Echinococcosis Surgery in Kashi Prefecture, Northwestern China: A Propensity Score Matching Analysis

Feasibility and Safety of Early Oral Intake and Discharge After Total or Proximal Gastrectomy: An Analysis of Consecutive Cases Without Exclusion Criteria

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