Validation of the Enhanced Recovery after Surgery (ERAS) society recommendations for liver surgery: a prospective, observational study

作     者：Moritz Schmelzle Felix Krenzien Paul Dahlke Alina Krombholz Nora Nevermann Linda Feldbrügge Axel Winter Wenzel Schoning Christian Benzing Johann Pratschke Jens Neudecker 

作者机构：Department of SurgeryCampus Charite Mitte and Campus Virchow-KlinikumCharite-Universitatsmedizincorporate member of Freie Universität BerlinHumboldt-Universitat zu BerlinBerlinGermany Berlin Institute of Health(BIH)BerlinGermany 

出 版 物：《Hepatobiliary Surgery and Nutrition》 (肝胆外科与营养（英文）)

年 卷 期：2023年第12卷第1期

页      面：20-36,I0003-I0006页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Enhanced Recovery After Surgery(ERAS) prehabilitation liver surger 

摘      要：Twenty-three recommendations were summarized by the Enhanced Recovery After Surgery(ERAS)society for liver *** aim was to validate the protocol especially with regard to adherence and the impact on ***:Using the ERAS Interactive Audit System(EIAS),ERAS items were evaluated in patients undergoing liver *** 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 *** adherence and complications were compared between the two ***: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 *** ERAS guidelines are beneficial for the outcome,while adherence to the various items has not yet been satisfactorily defined.