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强化康复方案对结直肠肝转移行肝切除术后长期生存的影响。

The effect of the enhanced recovery programme on long-term survival following liver resection for colorectal liver metastases.

机构信息

BRIDGES Research Group, Department of General and Hepatopancreatobiliary Surgery, East Lancashire Teaching Hospitals NHS Trust, Blackburn, BB2 3HH, UK.

Lancaster Medical School, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, LA1 4AT, UK.

出版信息

Langenbecks Arch Surg. 2023 Jun 19;408(1):239. doi: 10.1007/s00423-023-02968-4.

Abstract

BACKGROUND

Enhanced recovery programmes are associated with improved short-term outcomes following liver surgery. The impact of enhanced recovery programmes on medium- and long-term outcomes is incompletely understood. This study aimed to assess the impact of an enhanced recovery programme on long-term survival in patients undergoing surgery for colorectal liver metastases.

METHODS

At a tertiary hepatobiliary centre, we analysed short-, medium- and long-term outcomes in consecutive patients undergoing liver resection for colorectal liver metastases. A five-year retrospective review was carried out comparing the enhanced recovery programme to standard care.

RESULTS

A total of 172 patients were included in the analysis: 87 on standard care and 85 on an enhanced recovery programme. Open surgery was performed in 122 patients: 74 (85.1%) and 48 (56.5%) patients in the standard care and enhanced recovery programme, respectively (p < 0.001). There was a significant reduction in the median (IQR) length of hospital stay in the enhanced recovery programme compared with standard care (7 (5) days vs. 8 (3) days, p = 0.0009). There was no significant difference in survival between standard care and the Enhanced Recovery Programme at one (p = 0.818), three (p = 0.203), and five years (p = 0.247).

CONCLUSION

An enhanced recovery programme was associated with a reduced length of hospital stay. There was no effect on the one-, three- and five-year survival.

摘要

背景

强化康复方案与肝手术后短期结果的改善相关。强化康复方案对中、长期结果的影响尚不完全清楚。本研究旨在评估强化康复方案对结直肠肝转移患者手术长期生存的影响。

方法

在一家三级肝胆中心,我们分析了连续接受结直肠肝转移肝切除术的患者的短期、中期和长期结果。对强化康复方案与标准护理进行了为期五年的回顾性比较。

结果

共有 172 例患者纳入分析:标准护理组 87 例,强化康复方案组 85 例。122 例行开放手术:标准护理组和强化康复方案组分别有 74 例(85.1%)和 48 例(56.5%)(p<0.001)。与标准护理相比,强化康复方案的中位(IQR)住院时间明显缩短(7(5)天 vs. 8(3)天,p=0.0009)。标准护理和强化康复方案在 1 年(p=0.818)、3 年(p=0.203)和 5 年(p=0.247)时的生存率无显著差异。

结论

强化康复方案与住院时间缩短相关。对 1 年、3 年和 5 年生存率无影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5b6/10279559/0deeaa18377b/423_2023_2968_Fig1_HTML.jpg

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