The effectiveness of an enhanced recovery after surgery protocol in head and neck cancer surgery with free-flap reconstruction

Ho-Ryun Won; Jun-Young An; Jung Jun Lee; Dong Young Kim; Jeon Yeob Jang; Chul-Ho Kim; Yoo Seob Shin

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자료유형: 학술저널

저자정보: Ho-Ryun Won (Chungnam National University Hospital) Jun-Young An (Ajou University School of Medicine) Jung Jun Lee (Ajou University School of Medicine) Dong Young Kim (Ajou University School of Medicine) Jeon Yeob Jang (Ajou University School of Medicine) Chul-Ho Kim (Ajou University School of Medicine) Yoo Seob Shin (Ajou University School of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.5

발행연도: 2019.11

수록면: 239 - 244 (6page)

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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.

#Adjuvant radiotherapy #Free tissue flaps #Head and neck neoplasms #Perioperative care #Postoperative care

참고문헌 (12)

참고문헌 신청

Coyle MJ / 2016 / Enhanced recovery after surgery(ERAS)for head and neck oncology patients / Clin Otolaryngol 41:118~126

Dort JC / 2017 / Optimal perioperative care in major head and neck cancer surgery with free flap reconstruction : a consensus review and recommendations from the enhanced recovery after surgery society / JAMA Otolaryngol Head Neck Surg 143:292~303

곽승진 / 2014 / The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer / 대한외과학회지 86(4):206~211

Kehlet H / 1997 / Multimodal approach to control postoperative pathophysiology and rehabilitation / Br J Anaesth 78:606~617

Bianchini C / 2014 / Enhanced recovery after surgery(ERAS)strategies : possible advantages also for head and neck surgery patients / Eur Arch Otorhinolaryngol 271:439~443

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