Retrospective Study on the Application of Enhanced Recovery After Surgery Measures to Promote Postoperative Rehabilitation in 50 Patients With Brain Tumor Undergoing Craniotomy

Abstract

ObjectiveTo investigate whether enhanced recovery after surgery (ERAS) can promote rehabilitation of patients after neurosurgical craniotomy.MethodsThe clinical data of 100 patients with brain tumor undergoing craniotomy in the Department of Neurosurgery, Xiangya Hospital, Central South University, from January 2018 to August 2020 were collected, including 50 patients in the ERAS group and 50 patients in the control group. t-Test, Wilcoxon’s rank sum test, and chi-square analysis were used to compare the clinical characteristics, prognosis, and hospitalization time between the two groups.ResultsThere was no significant difference in gender, age, and other general clinical data between the two groups (p > 0.05). The days of antiemetic drugs applied in the ERAS group were less than those in the control group (1.00 vs. 2.00 days, p = 0.003), and the proportion of patients requiring analgesics was lower than that of the control group (30% vs. 52%, OR = 0.41, 95% CI 0.18–0.93, p = 0.031). The time of urinary catheter removal and that of patients starting ambulation in the ERAS group were shorter than those in the control group (16.00 vs. 24.00 h, and 1.00 vs. 2.00 days, p < 0.001, respectively); and the hospital length of stay (LOS) in the ERAS group was shorter than that in the control group (Total LOS, 13.00 vs. 15.50 days; Postoperative LOS, 7.00 vs. 10.00 days, p < 0.001). By analyzing the prognosis of patients in the ERAS group and control group, we found that there was no significant difference in postoperative complications and Karnofsky Performance Status (KPS) score 1 month after operation between the two groups.ConclusionThe application of ERAS in craniotomy can accelerate the postoperative recovery of patients without increasing the perioperative risk, which is worthy of wide application. However, whether the ERAS measures can reduce the postoperative complications and improve the prognosis of patients still needs more large-scale case validation and multicenter collaborative study.

Untitled

“…Movement and early mobilization following brain tumor surgery have proven to be effective in facilitating patients' recovery. However, patients may exhibit reluctance or encounter difficulties when it comes to movement, primarily due to the pain they experience, the presence of various care equipment attached to their bodies, and the fear of potential damage to the surgical site (Wang et al, 2019;Feng et al, 2021). Patients who have undergone spinal surgery (Archer K et al, 2014), as well as those with lumbar disc herniation (Svensson et al, 2011) and lumbar spinal surgery (Kemani et al., 2020), often experience fear of movement, which subsequently leads to reduced participation in physical activities.…”

Real-World Implementation of Neurosurgical Enhanced Recovery After Surgery Protocol for Gliomas in Patients Undergoing Elective Craniotomy

“…Our current results confirmed this measure to be safe and effective for glioma patients. In addition, early mobilization can reduce the risk of pulmonary complications and DVT, as well as improve cardiopulmonary function ( 16 , 17 ). In our case series, patients in the ERAS group were encouraged to ambulate on the first day after the operation, which was associated with shorter LOS and better rehabilitation.…”

Effect of the enhanced recovery protocol in patients with brain tumors undergoing elective craniotomies: a systematic review and meta-analysis

“…Mortality was reported in 7 studies, 9,[36][37][38][40][41][42] and a pooled analysis of these studies revealed no significant differences in mortality between the ERP and non-ERP groups, with 4 deaths reported in each group. The incidence of the other complications was also not significantly different between the ERP and non-ERP groups (Table 3).…”

“…All records from the citation search were excluded after fulltext screening of individual ERP interventions. [27][28][29][30][31][32][33][34][35] Subsequently, 8 records, 9,36-42 including 3 RCTs, 9,36,37 3 prospective studies, 39,40,42 and 2 retrospective studies 38,41 published between 2019 and 2022, were included (Table 1).…”

“…The remaining studies represent a severe risk of bias due to unclear outcome measurements. Among the 5 non-RCTs, 4 cases of moderate risk of bias, 38,[40][41][42] and 1 case of severe risk of bias due to a lack of information regarding participant selection 41 were identified (Supplementary Fig. 1).…”