Impact of Enhanced Recovery After Surgery on Long-Term Outcomes and Postoperative Recovery in Patients Undergoing Hepatectomy: A Retrospective Cohort Study

Zhang, Zhao; Gu, Weidong; Zhang, Yijing

doi:10.2147/cmar.s301859

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…The elements of the ERAS protocol in each article are presented in Table 2 . The number of ERAS elements in the included articles ranged from 3 to 18, and 17 articles described a protocol containing more than 10 elements [ 11 , 13 – 18 , 21 , 22 , 24 , 26 , 27 , 29 , 30 , 32 – 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three studies reported long-term cancer-specific survival (CSS) [ 11 , 12 , 33 ], and 4 studies reported long-term disease-free survival (DFS) [ 16 , 29 – 31 ].The follow-up time ranged from 10 months to 10 years, 1 study showed that ERAS could improve CSS [ 33 ] and DFS [ 30 ], while the others found no differences. One study [ 31 ] reported recurrence and metastasis, the result found no difference between conventional care and ERAS.…”

Section: Resultsmentioning

confidence: 99%

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Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries — a systematic review

et al. 2021

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Background Clinical evidence has proved that enhanced recovery after surgery (ERAS) can improve short-term clinical outcomes after various types of surgeries, but the long-term benefits have not yet been examined, especially with respect to cancer surgeries. Therefore, a systematic review of the current evidence was conducted. Methods The Pubmed, Cochrane Library, Embase, and Web of Science databases were searched using the following key words as search terms: “ERAS” or “enhanced recovery” or “fast track”, “oncologic outcome”, “recurrence”, “metastasis”, “long-term outcomes”, “survival”, and “cancer surgery”. The articles were screened using the inclusion and exclusion criteria, and the data from the included studies were extracted and analyzed. Results A total of twenty-six articles were included in this review. Eighteen articles compared ERAS and conventional care, of which, 12 studies reported long-term overall survival (OS), and only 4 found the improvement by ERAS. Four studies reported disease-free survival (DFS), and only 1 found the improvement by ERAS. Five studies reported the outcomes of return to intended oncologic treatment after surgery (RIOT), and 4 found improvements in the ERAS group. Seven studies compared high adherence to ERAS with low adherence, of which, 6 reported the long-term OS, and 3 showed improvements by high adherence. One study reported high adherence could reduce the interval from surgery to RIOT. Four studies reported the effect of altering one single item within the ERAS protocol, but the results of 2 studies were controversial regarding the long-term OS between laparoscopic and open surgery, and 1 study showed improvements in OS with restrictive fluid therapy. Conclusions The use of ERAS in cancer surgeries can improve the on-time initiation and completion of adjuvant chemotherapy after surgery, and the high adherence to ERAS can lead to better outcomes than low adherence. Based on the current evidence, it is difficult to determine whether the ERAS protocol is associated with long-term overall survival or cancer-specific survival.

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