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PLoS One. 2016 Mar 7;11(3):e0150782. doi: 10.1371/journal.pone.0150782. eCollection 2016.

Safety of an Enhanced Recovery Pathway for Patients Undergoing Open Hepatic Resection.

Author information

1
Department of General Surgery, Wake Forest Baptist Health, Winston-Salem, North Carolina, United States of America.
2
Division of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, Minnesota, United States of America.
3
Department of General Surgery, University of Virginia, Charlottesville, Virginia, United States of America.
4
Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, United States of America.

Abstract

BACKGROUND:

Enhanced recovery pathways (ERP) have not been widely implemented for hepatic surgery. The aim of this study was to evaluate the safety of an ERP for patients undergoing open hepatic resection.

METHODS:

A single-surgeon, retrospective observational cohort study was performed comparing the clinical outcomes of patients undergoing open hepatic resection treated before and after implementation of an ERP. Morbidity, mortality, and length of hospital stay (LOS) were compared between pre-ERP and ERP groups.

RESULTS:

126 patients (pre-ERP n = 73, ERP n = 53) were identified for the study. Patient characteristics and operative details were similar between groups. Overall complication rate was similar between pre-ERP and ERP groups (37% vs. 28%, p = 0.343). Before and after pathway implementation, the median LOS was similar, 5 (IQR 4-7) vs. 5 (IQR 4-6) days, p = 0.708. After adjusting for age, type of liver resection, and ASA, the ERP group had no increased risk of major complication (OR 0.38, 95% CI 0.14-1.02, p = 0.055) or LOS greater than 5 days (OR 1.21, 95% CI 0.56-2.62, p = 0.627).

CONCLUSIONS:

Routine use of a multimodal ERP is safe and is not associated with increased postoperative morbidity after open hepatic resection.

PMID:
26950852
PMCID:
PMC4780831
DOI:
10.1371/journal.pone.0150782
[Indexed for MEDLINE]
Free PMC Article

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