The development, application and analysis of an enhanced recovery programme for major oesophagogastric resection
The development, application and analysis of an enhanced recovery programme for major oesophagogastric resection
Background: Enhanced recovery programmes improve outcomes in surgery, but their implementation after upper gastrointestinal resection has been limited. The aim of this study was to compare short-term outcomes for patients undergoing oesophagogastric surgery in an enhanced recovery programme (EROS). Methods: EROS was developed after a multidisciplinary meeting by multiple rounds of revision. EROS was applied to all patients undergoing major upper GI resection at a university teaching hospital in the UK from 20/9/13, with data reviewed at 18/09/15. EROS was assessed to identify predictors for compliance. Results: One hundred six patients underwent major upper GI resection including 81 oesophagectomies, 24 gastrectomies and 1 colonic interposition graft. Major complications (ClavienDindo≥3) occurred in 12 patients with 1 in-hospital death. Thirty-five patients (44%) were discharged on target day 8 of the EROS programme. Age and complications were independently associated with missing this discharge target. Conclusion: Enhanced recovery is feasible and safe after major upper gastrointestinal surgery.
614-621
Underwood, Timothy J.
8e81bf60-edd2-4b0e-8324-3068c95ea1c6
Noble, F.
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Madhusudan, N.
104e851c-9cf9-4b95-8081-f7c2f8e913ae
Sharland, D.
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Fraser, R.
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Owsley, J.
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Grant, M.
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Kelly, J.J.
ab65aaf7-98c0-4b4f-8956-ce5d2a172dcf
Byrne, James P.
e3d5b8fe-1b69-441c-a173-e084fe5372a6
1 April 2017
Underwood, Timothy J.
8e81bf60-edd2-4b0e-8324-3068c95ea1c6
Noble, F.
4f14574c-28f2-4e04-bd95-f53c7649e1fa
Madhusudan, N.
104e851c-9cf9-4b95-8081-f7c2f8e913ae
Sharland, D.
e5204383-3b61-43cb-a21a-5afd2d5786db
Fraser, R.
1d2e1003-e025-4cb6-b411-5687fa2f5e0f
Owsley, J.
4081d876-5a5f-46e7-aec3-5a844557b734
Grant, M.
f9b7dd1c-68af-4fdd-81d4-274f9577c9b5
Kelly, J.J.
ab65aaf7-98c0-4b4f-8956-ce5d2a172dcf
Byrne, James P.
e3d5b8fe-1b69-441c-a173-e084fe5372a6
Underwood, Timothy J., Noble, F., Madhusudan, N., Sharland, D., Fraser, R., Owsley, J., Grant, M., Kelly, J.J. and Byrne, James P.
(2017)
The development, application and analysis of an enhanced recovery programme for major oesophagogastric resection.
Journal of Gastrointestinal Surgery, 21 (4), .
(doi:10.1007/s11605-017-3363-8).
(PMID:28120276)
Abstract
Background: Enhanced recovery programmes improve outcomes in surgery, but their implementation after upper gastrointestinal resection has been limited. The aim of this study was to compare short-term outcomes for patients undergoing oesophagogastric surgery in an enhanced recovery programme (EROS). Methods: EROS was developed after a multidisciplinary meeting by multiple rounds of revision. EROS was applied to all patients undergoing major upper GI resection at a university teaching hospital in the UK from 20/9/13, with data reviewed at 18/09/15. EROS was assessed to identify predictors for compliance. Results: One hundred six patients underwent major upper GI resection including 81 oesophagectomies, 24 gastrectomies and 1 colonic interposition graft. Major complications (ClavienDindo≥3) occurred in 12 patients with 1 in-hospital death. Thirty-five patients (44%) were discharged on target day 8 of the EROS programme. Age and complications were independently associated with missing this discharge target. Conclusion: Enhanced recovery is feasible and safe after major upper gastrointestinal surgery.
Text
EROS Final_Revision_2.pdf
- Accepted Manuscript
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Accepted/In Press date: 4 January 2017
e-pub ahead of print date: 24 January 2017
Published date: 1 April 2017
Organisations:
Cancer Sciences
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Local EPrints ID: 405484
URI: http://eprints.soton.ac.uk/id/eprint/405484
ISSN: 1091-255X
PURE UUID: 1505a1ac-2832-4278-be98-c00f5987ea6a
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Date deposited: 07 Feb 2017 09:56
Last modified: 16 Mar 2024 03:35
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Contributors
Author:
F. Noble
Author:
N. Madhusudan
Author:
D. Sharland
Author:
R. Fraser
Author:
J. Owsley
Author:
M. Grant
Author:
J.J. Kelly
Author:
James P. Byrne
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