@article{47082854cadc4f8e84d76aa253ed98d8,
title = "Implementation of a perioperative-enhanced recovery protocol in patients undergoing open gastrectomy for gastric cancer",
abstract = "Background and Objectives: The purpose of this study was to compare surgical outcomes before and after implementation of an enhanced recovery protocol (ERP) in gastrectomy for gastric cancer. Methods: We included patients who underwent open gastrectomy for gastric cancer before (January 2016 to September 2018) or after (October 2018 to September 2020) ERP implementation. The primary outcome was the postoperative length of stay (LOS). Secondary outcomes included 90-day readmission rates and Clavien–Dindo grade ≥ 3 complications. Results: One hundred patients underwent gastrectomy before (pre-ERP group) and 52 underwent gastrectomy after (ERP group) protocol implementation. Demographic and clinicopathologic characteristics were similar. The median (interquartile range) postoperative LOS was shorter in the ERP group (7.0 days [6.0–8.0] vs. 8.0 days [7.0–11.0]; p < 0.001). The ERP group had similar rates of readmission (33% vs. 24%; p = 0.34) and grade ≥ 3 complications (19% vs. 19%; p = 1.0) compared to the pre-ERP group, but experienced lower rates of surgical wound complications (0% vs. 19%; p < 0.001). Rates of other complications were similar. Conclusions: Implementation of an ERP in patients undergoing open gastrectomy for gastric cancer is feasible and safe and has the potential to decrease postoperative LOS without increasing complication rates.",
keywords = "enhanced recovery after surgery, fast-track surgery, gastrectomy, gastric cancer, stomach neoplasms",
author = "Blumenthaler, {Alisa N.} and Robinson, {Kristen A.} and Kruse, {Brittany C.} and Kathryn Munder and Naruhiko Ikoma and Mansfield, {Paul F.} and Vijaya Gottumukkala and Ravish Kapoor and Badgwell, {Brian D.}",
note = "Funding Information: The authors thank the MD Anderson Enhanced Recovery team for their role in designing, implementing, monitoring, and improving the enhanced recovery protocol for patients with gastric cancer. The authors also acknowledge Stephanie Deming, Research Medical Library, MD Anderson Cancer Center, for editing assistance with this manuscript. This study was supported by the National Institutes of Health (grant numbers T32 CA009599 and P30 CA016672). This study was also supported by the Holly Clegg Gastric Cancer Research Fund and the No Stomach for Cancer Award for Gastric Cancer Research. The funding sources had no involvement in the study design, the writing of the report, or the decision to submit the article for publication. Funding Information: The authors thank the MD Anderson Enhanced Recovery team for their role in designing, implementing, monitoring, and improving the enhanced recovery protocol for patients with gastric cancer. The authors also acknowledge Stephanie Deming, Research Medical Library, MD Anderson Cancer Center, for editing assistance with this manuscript. This study was supported by the National Institutes of Health (grant numbers T32 CA009599 and P30 CA016672). This study was also supported by the Holly Clegg Gastric Cancer Research Fund and the No Stomach for Cancer Award for Gastric Cancer Research. The funding sources had no involvement in the study design, the writing of the report, or the decision to submit the article for publication. Publisher Copyright: {\textcopyright} 2021 Wiley Periodicals LLC",
year = "2021",
month = oct,
day = "1",
doi = "10.1002/jso.26591",
language = "English (US)",
volume = "124",
pages = "780--790",
journal = "Journal of surgical oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "5",
}