Implementation of the ERAS protocol for liver surgery significantly reduced overall complications compared to non-ERAS care (26.5% vs 41.2%, P=0.0423).
Observational (n=304)
Does the implementation of the ERAS protocol reduce perioperative complications in patients undergoing liver resection?
Implementation of the ERAS protocol for liver surgery significantly reduces perioperative complications, particularly grade 1-2 complications.
Absolute Event Rate: 26.5% vs 41.2%
p-value: p=0.0423
Background: Twenty-three recommendations were summarized by the Enhanced Recovery After Surgery (ERAS) society for liver surgery. The aim was to validate the protocol especially with regard to adherence and the impact on morbidity. Methods: Using the ERAS Interactive Audit System (EIAS), ERAS items were evaluated in patients undergoing liver resection. Over a period of 26 months, 304 patients were prospectively enrolled in an observational study (DRKS00017229). Of those, 51 patients (non-ERAS) were enrolled before and 253 patients (ERAS) after the implementation of the ERAS protocol. Perioperative adherence and complications were compared between the two groups. Results: Overall adherence increased from 45.2% in the non-ERAS group to 62.7% in the ERAS group (P0.05). Overall complications decreased from 41.2% (n=21) in the non-ERAS group to 26.5% (n=67) in the ERAS group (P=0.0423), which was mainly due to the reduction of grade 1-2 complications from 17.6% (n=9) to 7.6% (n=19) (P=0.0322). As for patients undergoing open surgery, implementation of ERAS lead to a reduction of overall complications in patients scheduled for minimally invasive liver surgery (MILS) (P=0.036). Conclusions: Implementation of the ERAS protocol for liver surgery according to the ERAS guidelines of the ERAS Society reduced Clavien-Dindo grade 1-2 complications particularly in patients who underwent MILS. The ERAS guidelines are beneficial for the outcome, while adherence to the various items has not yet been satisfactorily defined.
Schmelzle et al. (Thu,) conducted a observational in Liver surgery (n=304). Enhanced Recovery After Surgery (ERAS) protocol vs. Non-ERAS (before implementation) was evaluated on Overall complications (p=0.0423). Implementation of the ERAS protocol for liver surgery significantly reduced overall complications compared to non-ERAS care (26.5% vs 41.2%, P=0.0423).