Implementation Of A Enhanced Recovery After Surgery Clinical Pathway In Patients Undergoing Hepatectomy For Primary Liver Cancer

Objective This study was aiming to investigate the safety and efficiency of hepatectomy for primary liver cancer managed with enhanced recovery after surgery(ERAS) concept, provide a reference to sum up clinical strategies that in line with china’s national conditionsMethods 90 patients with primary liver cancer who were admitted to the affiliated provincial hospital of anhui medical university were enrolled in the study. According to different methods of perioperative management, all cases were assigned into ERAS group(n=45), C group(n=45). Outcome measures were time to the achievement of functional recovery, postoperative length of stay(LOS), hospital charges, postoperative complication, numerical rating scale(NRS) on postoperative 24 h, 48 h, the incidence of postoperative pain, time to independent mobility, time to resumption of diet, time to first passage of flatus, readmission rate, mortality.Results The perioperative data between the two groups of patients showed no statistical difference. Compared with the C group, the ERAS group had significantly longer operation time(t=5.158, P=0.00), lesser blood loss(t=2.339, P=0.02), shorter time to the achievement of functional recovery(t=4.003, P=0.000) and postoperative LOS(t=3.090, P=0.003), less hospital charges(t=2.281, P=0.025), lower general postoperative complication(c2=4.286, P=0.038), lower NRS on postoperative 24 h, 48h(t=2.851, 3.890, P=0.005, 0.000), lower incidence of postoperative pain(c2=3.986,P=0.046), shorter time to independent mobility(c2=21.485, P=0.000), shorter time to resumption of diet(c2=82.410, P=0.000), shorter time to first passage of flatus(t=2.390, P=0.019).Conclusion ERAS was safe and efficacious. It lessened postoperative LOS and hospital charges and accelerated recovery for patients undergoing hepatectomy for primary liver cancer.