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Randomized Controlled Trial Comparing the Short-term Outcomes of Enhanced Recovery After Surgery and Conventional Care in Laparoscopic Distal Gastrectomy (GISSG1901)

  • 编号:
    4B441617E720B842FBB5965213482441
  • 作者:
    Tian, Yulong(tianyulong)#[1] Cao, Shougen[1] Liu, Xiaodong[1] Li, Leping[2] He, Qingsi[3] Jiang, Lixin[4] Wang, Xinjian[5] Chu, Xianqun[6] Wang, Hao[7] Xia, Lijian[8] Ding, Yinlu[9] Mao, Weizheng[10] Hui, Xizeng[11] Shi, Yiran[12] Zhang, Huanhu[13] Niu, Zhaojian[1] Li, Zequn[1] Jiang, Haitao[1] Kehlet, Henrik(kehlethenrik)*[14] Zhou, Yanbing(zhouyanbing)*[1]
  • 语种:
    英文
  • 期刊:
    ANNALS OF SURGERY ISSN:0003-4932 2022 年 275 卷 1 期 (E15 - E21) ; JAN
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  • 摘要:

    Objective: This study aimed to compare the effects of ERAS and conventional programs on short-term outcomes after LDG. Summary of Background Data: Currently, the ERAS program is broadly applied in surgical areas. Although several benefits of LDG with the ERAS program have been covered, high-level evidence is still limited, specifically in advanced gastric cancer. Methods: The present study was designed as a randomized, multicenter, unblinded trial. The enrollment criteria included histologically confirmed cT2-4aN0-3M0 gastric adenocarcinoma. Postoperative complications, mortality, readmission, medical costs, recovery, and laboratory outcomes were compared between the ERAS and conventional groups. Results: Between April 2019 and May 2020, 400 consecutive patients who met the enrollment criteria were enrolled. They were randomly allocated to either the ERAS group (n = 200) or the conventional group (n = 200). After excluding patients who did not undergo surgery or gastrectomy, 370 patients were analyzed. The patient demographic characteristics were not different between the 2 groups. The conventional group had a significantly longer allowed day of discharge and postoperative hospital stay (6.96 vs 5.83 days, P < 0.001; 8.85 vs 7.27 days, P < 0.001); a longer time to first flatus, liquid intake and ambulation (3.37 vs 2.52 days, P < 0.001; 3.09 vs 1.13 days, P < 0.001; 2.85 vs 1.38 days, P < 0.001, respectively); and higher medical costs (6826 vs 6328 $, P = 0.027) than the ERAS group. Additionally, patients in the ERAS group were more likely to initiate adjuvant chemotherapy earlier (29 vs 32 days, P = 0.035). There was no significant difference in postoperative complications or in the mortality or readmission rates. Regarding laboratory outcomes, the procalcitonin and C-reactive protein levels on postoperative day 3 were significantly lower and the hemoglobin levels on postoperative day 5 were significantly higher in the ERAS group than in the conventional group. Conclusion: The ERAS program provides a faster recovery, a shorter postoperative hospitalization length, and lower medical costs after LDG without increasing complication and readmission rates. Moreover, enhanced recovery in the ERAS group enables early initiation of adjuvant chemotherapy.

  • 推荐引用方式
    GB/T 7714:
    Tian Yulong,Cao Shougen,Liu Xiaodong, et al. Randomized Controlled Trial Comparing the Short-term Outcomes of Enhanced Recovery After Surgery and Conventional Care in Laparoscopic Distal Gastrectomy (GISSG1901) [J].ANNALS OF SURGERY,2022,275(1):E15-E21.
  • APA:
    Tian Yulong,Cao Shougen,Liu Xiaodong,Li Leping,&Zhou Yanbing.(2022).Randomized Controlled Trial Comparing the Short-term Outcomes of Enhanced Recovery After Surgery and Conventional Care in Laparoscopic Distal Gastrectomy (GISSG1901) .ANNALS OF SURGERY,275(1):E15-E21.
  • MLA:
    Tian Yulong, et al. "Randomized Controlled Trial Comparing the Short-term Outcomes of Enhanced Recovery After Surgery and Conventional Care in Laparoscopic Distal Gastrectomy (GISSG1901)" .ANNALS OF SURGERY 275,1(2022):E15-E21.
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