Universität zu Köln

Mallmann, C., Drinhaus, H., Fuchs, H., Schiffmann, L. M., Cleff, C., Schoenau, E., Bruns, C. J., Annecke, T. and Schroeder, W. . Perioperative enhanced recovery after surgery program for Ivor Lewis esophagectomy First experiences of a high-volume center. Chirurg. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0385

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Abstract

Background and objective Transthoracic esophagectomy is generally accepted as the standard of surgical care for patients with esophageal cancer. Despite improvements in the perioperative management this surgical procedure is associated with a clinically relevant morbidity. Fast-track protocols (synonym: enhanced recovery after surgery, ERAS) are conceived to perioperatively maintain the physiological homoeostasis and thereby to accelerate postoperative rehabilitation and reduce morbidity. In this prospective observational study the initial experiences of a high-volume center with the implementation of an ERAS protocol after transthoracic esophagectomy were analyzed. Material and methods A total of 26 patients with esophageal cancer and a low index of comorbidities prior to hybrid Ivor Lewis esophagectomy were included in this study. According to an ERAS protocol all patients underwent a standardized perioperative treatment pathway aiming to discharge the patients from the inpatient treatment on postoperative day 10. The primary outcome parameter was the rate of major complications (Clavien-Dindo IIIb/IV), which was compared to a cohort of 52 non-ERAS patients. Results and conclusion The ERAS programs with the various core elements can be implemented in patients scheduled for transthoracic esophagectomy, although the organizational and personnel expenditure of this fast-track protocol is high. The length of hospital stay appears to be reduced without compromising patient safety. The limiting variable of the ERAS protocol remains the early and adequate enteral feeding load of the gastric conduit before discharge on postoperative day 10.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mallmann, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Drinhaus, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fuchs, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schiffmann, L. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Cleff, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenau, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, C. J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Annecke, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-329900
DOI:	10.1007/s00104-020-01216-5
Journal or Publication Title:	Chirurg
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0385
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MINIMALLY-INVASIVE-ESOPHAGECTOMY; IMPROVE OUTCOMES; OPEN-LABEL; CANCER; COMPLICATIONS; MULTICENTER; IMPACT; METAANALYSIS; MANAGEMENT; MORTALITY Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32990