Reduction in length of stay for patients undergoing oesophageal and gastric resections with implementation of enhanced recovery packages

The high mortality and morbidity associated with resection for oesophagogastric malignancy has resulted in a conservative approach to the postoperative management of this patient group. In August 2009 we introduced an enhanced recovery after surgery (ERAS) pathway tailored to patients undergoing res...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2013-07, Vol.95 (5), p.323-328
Main Authors: Tang, J, Humes, D J, Gemmil, E, Welch, N T, Parsons, S L, Catton, J A
Format: Article
Language:English
Subjects:
Aged
Colorectal surgery
Critical care
Critical Pathways - statistics & numerical data
Esophageal Neoplasms - surgery
Esophagectomy - rehabilitation
Esophagectomy - statistics & numerical data
Esophagus
Female
Gastrectomy - rehabilitation
Gastrectomy - statistics & numerical data
Gastric cancer
Hospital costs
Humans
Laparoscopy - rehabilitation
Laparoscopy - statistics & numerical data
Length of Stay - statistics & numerical data
Male
Middle Aged
Morbidity
Mortality
Nutrition research
Ostomy
Patient satisfaction
Perioperative Care - methods
Pneumonia
Postoperative Complications - rehabilitation
Prospective Studies
Recovery of Function
Stomach Neoplasms - surgery
Treatment Outcome
Upper GI
Ventilators
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Summary:The high mortality and morbidity associated with resection for oesophagogastric malignancy has resulted in a conservative approach to the postoperative management of this patient group. In August 2009 we introduced an enhanced recovery after surgery (ERAS) pathway tailored to patients undergoing resection for oesophagogastric malignancy. We aimed to assess the impact of this change in practice on standard clinical outcomes. Two cohorts were studied of patients undergoing resection for oesophagogastric malignancy before (August 2008 - July 2009) and after (August 2009 - July 2010) the implementation of the ERAS pathway. Data were collected on demographics, interventions, length of stay, morbidity and in-hospital mortality. There were 53 and 55 oesophagogastric resections undertaken respectively for malignant disease in each of the study periods. The median length of stay for both gastric and oesophageal resection decreased from 15 to 11 days (Mann-Whitney U, p
ISSN:0035-8843
1478-7083
DOI:10.1308/003588413X13629960046039