Title: Is Enhanced Recovery After Gastric Surgery Feasible For Gastric Cancer in Our Setup
Authors: Mubashir A Shah, Mudasir Habib, Ishfaq A parrah, Sameer H Naqash
DOI: https://dx.doi.org/10.18535/jmscr/v6i3.201
Abstract
Background: Enhanced recovery after surgery (ERAS) is a new concept of perioperative patient care that focuses on the minimization of impact of surgery on patients homeostasis. The concept is being routinely practised in colorectal surgeries but there are only a few studies on its application and safety in Upper Gastrointestinal surgeries . We undertook this study to look for the advantages and feasibility of ERAS in Gastric Resections in our Institute.
Methods: This Prospective study consisted of 100 patients randomly assigned to two groups, ERAS group (n= 50) and Control Or Traditional group(n= 50), operated in the Department of Surgery between 2013 and 2016. All patients managed as per ERAS protocol were compared with controls in terms of time of mobilization, appearance of bowel function, initiation of enteral feeding, development of complications and length of hospital stay. Data was recorded and analysed.
Results: Patients in the ERAS group were mobile early (on zero post op day VS control on 1pod),NG tubes were removed earlier (2nd POD VS 3RD – 4TH POD ),resumed orals earlier (ON 3RD POD VS 5TH POD),bowel functional returned back to normal much earlier than those in control group . Hospital stay was much lower in ERAS group (mean 5 days vs 8.5 days) .Patients in the both groups were comparable in terms of postoperative complications .Readmission within 30 days of Discharge was higher for ERAS Group compared to Control (4%vs0.0%)
Conclusion: The principles of ERAS in Gastric Resections are applicable and beneficial and decreases the hospital stay without increasing the risk of complications.
Keywords: ERAS, gastrectomy, ambulation, recovery.
