Application of Enhanced Recovery after Surgery in Hepatic Hemangioma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 CHENGYa ,  JIAWei-dong

Department of Hepatic Surgery, Affiliated Provincial Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China;

Corresponding?author：

JIAWei-dong, Email: jwd1968@sina.com

Keywords：

Enhance recovery after surgery; Hepatic hemangioma

DOI：

10.7507/1007-9424.20160040

Video：

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Objective To explore effectiveness and rationality of using concept of enhanced recovery after surgery in treatment of hepatic hemangioma. Methods The clinical data of 289 patients with hepatic hemangioma underwent hepatectomy were analyzed retrospectively.These patients were divided into enhanced recovery after surgery group (n=146) and traditional perioperative treatment group (n=143) according to the different perioperative treatment methods.The postoperative hospital stay,hospitalization cost,postoperative bilirubin levels on day 1,3,and 5,postoperative complications rate,postoperative 24 h and 48 h pain numeric rating scale (NRS) score,postoperative ambulation status,intestinal ventilation time,mortality,and readmission rate were compared between these two groups. Results Compared with the traditional perioperative treatment group,the postoperative hospital stay and intestinal ventilation time were shorter (P<0.05),hospitalization cost was less (P<0.05),postoperative complications rate was lower (P<0.05),points of postoperative 24 h and 48 h NRS were lower (P<0.05),proportion of postoperative ambulation on day 1 was higher (P<0.05) in the enhanced recovery after surgery group.While the differences of the postoperative bilirubin levels on day 1,3,and 5,mortality,and readmission rate were not significantly different between these two groups (P>0.05). Conclusion The concept of enhanced recovery after surgery in treatment of hepatic hemangioma is feasible and safe,which is in favor of postoperative functional recovery,and could shorten postoperative hospital stay and reduce hospitalization cost.

Citation： CHENGYa, JIAWei-dong. Application of Enhanced Recovery after Surgery in Hepatic Hemangioma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(2): 147-150. doi: 10.7507/1007-9424.20160040 Copy

1.	?Choi BY, Nguyen MH. The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol, 2005, 39(5):401-412.
2.	Trotter JF, Everson GT. Benign focal lesions of the liver. Clin Liver Dis, 2001, 5(1):17-42.
3.	Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284):473-476.
4.	Fayezizadeh M, Petro CC, Rosen MJ. Enhanced recovery after surgery pathway for abdominal wall reconstruction:pilot study and preliminary outcomes. Plast Reconstr Surg, 2014, 134(4, 2):151S-159S.
5.	Ni CY, Yang Y, Chang YQ, et al. Fast-track surgery improves postoperative recovery in patients undergoing partial hepatectomy for primary liver cancer:A prospective randomized controlled trial. Eur J Surg Oncol, 2013, 39(6):542-547.
6.	姜洪池, 孫備, 王剛. 快速康復外科的新理念值得重視. 中華外科雜志, 2007, 45(9):577-579.
7.	Aarts MA, Okrainec A, Glicksman A, et al. Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Surg Endosc, 2012, 26(2):442-450.
8.	Schultz NA, Larsen PN, Klarskov B, et al. Evaluation of a fast-track programme for patients undergoing liver resection. Br J Surg, 2013, 100(1):138-143.
9.	Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth, 2002, 89(4):622-632.
10.	Gustafsson UO, Hausel J, Thorell AA, et al. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg, 2011, 146(5):571-577.
11.	Wakeling HG, Mcfall MR, Jenkins CS, et al. Intraoperative oesopha-geal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth, 2005, 95(5):634-642.
12.	許戈良, 莢衛東, 李建生, 等. 應用精細肝臟外科理念治療原發性肝癌53例. 世界華人消化雜志, 2010, 18(17):1824-1828.
13.	Connor S, Cross A, Sakowska M, et al. Effects of introducing an enhanced recovery after surgery programme for patients undergoing open hepatic resection. HPB (Oxford), 2013, 15(4):294-301.
14.	Carli F, Baldini G. Fast-track surgery:it is time for the anesthesio-logist to get involved! Minerva Anestesiol, 2011, 77(2):227-230.
15.	冷希圣, 莢衛東, 苗毅, 等. 普通外科圍手術期疼痛處理專家共識. 中華普通外科雜志, 2015, 30(2):166-173.
16.	莢衛東, 喬曉斐. 精準肝臟外科時代無痛病房建設. 中華消化外科雜志, 2014, 13(64):415-418.
17.	Jones C, Kelliher L, Dickinson M, et al. Randomized clinical trial on enhanced recovery versus standard care following open liver resection. Br J Surg, 2013, 100(8):1015-1024.
18.	Stevens MF, De Nes L, Hollmann MW. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery (Br J Surg, 2011, 98:1068-1078). Br J Surg, 2011, 98(12):1805.
19.	Pearse R, Dawson D, Fawcett J, et al. Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial[ISRCTN38797445]. Crit Care, 2005, 9(6):R687-R693.

1. ?Choi BY, Nguyen MH. The diagnosis and management of benign hepatic tumors. J Clin Gastroenterol, 2005, 39(5):401-412.
2. Trotter JF, Everson GT. Benign focal lesions of the liver. Clin Liver Dis, 2001, 5(1):17-42.
3. Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ, 2001, 322(7284):473-476.
4. Fayezizadeh M, Petro CC, Rosen MJ. Enhanced recovery after surgery pathway for abdominal wall reconstruction:pilot study and preliminary outcomes. Plast Reconstr Surg, 2014, 134(4, 2):151S-159S.
5. Ni CY, Yang Y, Chang YQ, et al. Fast-track surgery improves postoperative recovery in patients undergoing partial hepatectomy for primary liver cancer:A prospective randomized controlled trial. Eur J Surg Oncol, 2013, 39(6):542-547.
6. 姜洪池, 孫備, 王剛. 快速康復外科的新理念值得重視. 中華外科雜志, 2007, 45(9):577-579.
7. Aarts MA, Okrainec A, Glicksman A, et al. Adoption of enhanced recovery after surgery (ERAS) strategies for colorectal surgery at academic teaching hospitals and impact on total length of hospital stay. Surg Endosc, 2012, 26(2):442-450.
8. Schultz NA, Larsen PN, Klarskov B, et al. Evaluation of a fast-track programme for patients undergoing liver resection. Br J Surg, 2013, 100(1):138-143.
9. Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth, 2002, 89(4):622-632.
10. Gustafsson UO, Hausel J, Thorell AA, et al. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg, 2011, 146(5):571-577.
11. Wakeling HG, Mcfall MR, Jenkins CS, et al. Intraoperative oesopha-geal Doppler guided fluid management shortens postoperative hospital stay after major bowel surgery. Br J Anaesth, 2005, 95(5):634-642.
12. 許戈良, 莢衛東, 李建生, 等. 應用精細肝臟外科理念治療原發性肝癌53例. 世界華人消化雜志, 2010, 18(17):1824-1828.
13. Connor S, Cross A, Sakowska M, et al. Effects of introducing an enhanced recovery after surgery programme for patients undergoing open hepatic resection. HPB (Oxford), 2013, 15(4):294-301.
14. Carli F, Baldini G. Fast-track surgery:it is time for the anesthesio-logist to get involved! Minerva Anestesiol, 2011, 77(2):227-230.
15. 冷希圣, 莢衛東, 苗毅, 等. 普通外科圍手術期疼痛處理專家共識. 中華普通外科雜志, 2015, 30(2):166-173.
16. 莢衛東, 喬曉斐. 精準肝臟外科時代無痛病房建設. 中華消化外科雜志, 2014, 13(64):415-418.
17. Jones C, Kelliher L, Dickinson M, et al. Randomized clinical trial on enhanced recovery versus standard care following open liver resection. Br J Surg, 2013, 100(8):1015-1024.
18. Stevens MF, De Nes L, Hollmann MW. Randomized clinical trial of epidural, spinal or patient-controlled analgesia for patients undergoing laparoscopic colorectal surgery (Br J Surg, 2011, 98:1068-1078). Br J Surg, 2011, 98(12):1805.
19. Pearse R, Dawson D, Fawcett J, et al. Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. A randomised, controlled trial[ISRCTN38797445]. Crit Care, 2005, 9(6):R687-R693.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Enhanced Recovery after Surgery in Hepatic Hemangioma

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