Enhanced recovery after surgery (ERAS) protocol in gastric cancer: Early term results
Murat Cikot1, Eyup Gemici1, Osman Kones1, Cevher Akarsu1, Halil Alis2
1Bakırkoy Dr. Sadi Konuk Training and Research Hospital, General Surgery, Istanbul, Turkey
2Istanbul Aydin University, Faculty of Medicine, Department of General Surgery, Istanbul, Turkey
Aim: To evaluate the effects of enhanced recovery after surgery (ERAS) protocol on morbidity and mortality in patients undergoing surgery due to gastric cancer.
Material and Methods: Data of a total of 40 patients who were operated due to gastric cancer with ERAS between May 2016 and December 2016 were retrospectively analyzed. Morbidity and mortality results were evaluated as local or systemic depending on whether they developed within postoperative 30 days and whether they developed due to operation. The American Society of Anesthesiologists (ASA) classification was used to assess preoperative risk. Surgical complications were classified according to the Clavien-Dindo classification and pathological staging was performed according to the Tumor, Node, Metastasis (TNM) classification.
Results: Four patients were in ASA I, 11 patients were in ASA II, 24 patients were in ASA III, and one patient was in ASA IV. The mean duration of surgery was 165 (range: 150 to 210) min in total gastrectomy and 115 (range: 95 to 140) min in subtotal gastrectomy. According to the TNM classification, four patients had Stage I, 10 patients had Stage II, and 26 patients had Stage III disease. The mean duration of hospitalization was nine (range: 6 to 21) days in total gastrectomy and six (range: 4 to 15) days in subtotal gastrectomy. The number of morbidities was 15% with a 2.5% mortality rate.
Conclusion: Our study results suggest that ERAS protocol is an evidence-based quality protocol which can be reliably applied even in advanced stage gastric cancer with a high ASA score.
Keywords: Gastric Cancer; Enhanced Recovery After Surgery; Morbidity; Mortality.