The effectiveness of an enhanced recovery after surgery protocol in head and neck cancer surgery with free-flap reconstruction
10.4174/astr.2019.97.5.239
- Author:
Ho Ryun WON
1
;
Jun Young AN
;
Jung Jun LEE
;
Dong Young KIM
;
Jeon Yeob JANG
;
Chul Ho KIM
;
Yoo Seob SHIN
Author Information
1. Department of Otolaryngology-Head and Neck Surgery, Chungnam National University Hospital, Daejeon, Korea.
- Publication Type:Original Article
- Keywords:
Adjuvant radiotherapy;
Free tissue flaps;
Head and neck neoplasms;
Perioperative care;
Postoperative care
- MeSH:
Cohort Studies;
Comorbidity;
Demography;
Free Tissue Flaps;
Head and Neck Neoplasms;
Head;
Humans;
Length of Stay;
Medical Records;
Perioperative Care;
Postoperative Care;
Postoperative Complications;
Postoperative Period;
Prospective Studies;
Radiotherapy;
Radiotherapy, Adjuvant;
Rehabilitation;
Retrospective Studies
- From:Annals of Surgical Treatment and Research
2019;97(5):239-244
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: An enhanced recovery after surgery (ERAS) protocol incorporates up-to-date perioperative care principles; the primary aim in using an ERAS protocol is to reduce issues that delay the recovery and cause the complications. The aim of this study was to compare outcomes associated with head and neck cancer surgery with free-flap reconstruction before and after implementation of an ERAS protocol. METHODS: Outcomes were analyzed by dividing patients into 2 groups: 29 patients in the non-ERAS group and 60 patients in the ERAS group. The ERAS group performed a prospective observational cohort study of patients who underwent a head and neck cancer surgery with free-flap reconstruction in Ajou University Hospital from August 2015 to December 2017. The non-ERAS group retrospectively reviewed the medical records of patients who had undergone the same surgery from August 2012 to July 2015. RESULTS: Demographics, comorbidities, hospital length of stay (LOS), postoperative complications, starting time of rehabilitation, and postoperative periods before radiotherapy for the non-ERAS and ERAS groups were compared. Hospital LOS was significantly lower for patients whose care followed the ERAS protocol than for patients in the non-ERAS group (30.87 ± 20.72 days vs. 59.66 ± 40.43 days, P < 0.0001). CONCLUSION: In this study, hospital LOS was reduced through fast recovery after the implementation of the ERAS protocol. Therefore, the ERAS protocol appeared feasible and safe in head and neck cancer surgery with free-flap reconstruction.
