SP6.1.11 ; The Effect of the Enhanced Recovery Programme for Liver Surgery on Long Term Survival

Aims The Enhanced Recovery Programme for Liver Surgery (ERPLS) has been shown to promote functional recovery and reduce hospital stay. However, its effect on long term survival has yet to be established. The aim of this study was to determine the effect of the ERPLS on 5-year patient survival. Metho...

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Published in:British journal of surgery Vol. 108
Main Authors: Arujunan, Kalaiyarasi, Shugaba, Abdulwarith, Uwadiae, Harmony, Lambert, Joel, Sgourakis, Georgios, Subar, Daren
Format: Journal Article
Language:English
Published: Oxford Oxford University Press 01.10.2021
Subjects:
Hepatectomy
Liver
Multivariate analysis
ISSN:0007-1323, 1365-2168
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Abstract Aims The Enhanced Recovery Programme for Liver Surgery (ERPLS) has been shown to promote functional recovery and reduce hospital stay. However, its effect on long term survival has yet to be established. The aim of this study was to determine the effect of the ERPLS on 5-year patient survival. Methods This was a retrospective study of patients who underwent liver resection for colorectal liver metastasis (CRLM) between January 2011 and December 2016 at a regional hepatobiliary centre. The cohort comprised of 60 pre-ERPLS and 60 post-ERPLS patients. The primary outcome was 5-year patient survival. The secondary outcomes were length of stay (LOS), postoperative complications and 90-day readmission rates. Multivariate analysis was performed to identify independent predictors of overall survival. Results There was no significant difference in the age (p = 0.960), gender (p = 0.332) and type of resection (p = 0.198) between both groups. ERPLS was not an independent predictor for overall survival (Gehan Wilcoxon Test, p = 0.828). There was no significant difference in the LOS (p = 0.874) and 90-day readmission rates (p = 0.349). Major postoperative complications (>3a Clavien-Dindo classification) were significantly less in the ERPLS group (p = 0.02). On multivariate analysis, positive resection margins and major postoperative complications were independent predictors for overall survival. Conclusions ERPLS does not seem to have an effect on long term patient survival. However, it appears to reduce the rate of major postoperative complications. LOS and 90-day readmission rates were not influenced by ERPLS.
AbstractList Aims The Enhanced Recovery Programme for Liver Surgery (ERPLS) has been shown to promote functional recovery and reduce hospital stay. However, its effect on long term survival has yet to be established. The aim of this study was to determine the effect of the ERPLS on 5-year patient survival. Methods This was a retrospective study of patients who underwent liver resection for colorectal liver metastasis (CRLM) between January 2011 and December 2016 at a regional hepatobiliary centre. The cohort comprised of 60 pre-ERPLS and 60 post-ERPLS patients. The primary outcome was 5-year patient survival. The secondary outcomes were length of stay (LOS), postoperative complications and 90-day readmission rates. Multivariate analysis was performed to identify independent predictors of overall survival. Results There was no significant difference in the age (p = 0.960), gender (p = 0.332) and type of resection (p = 0.198) between both groups. ERPLS was not an independent predictor for overall survival (Gehan Wilcoxon Test, p = 0.828). There was no significant difference in the LOS (p = 0.874) and 90-day readmission rates (p = 0.349). Major postoperative complications (>3a Clavien-Dindo classification) were significantly less in the ERPLS group (p = 0.02). On multivariate analysis, positive resection margins and major postoperative complications were independent predictors for overall survival. Conclusions ERPLS does not seem to have an effect on long term patient survival. However, it appears to reduce the rate of major postoperative complications. LOS and 90-day readmission rates were not influenced by ERPLS.
Author Subar, Daren
Arujunan, Kalaiyarasi
Lambert, Joel
Sgourakis, Georgios
Uwadiae, Harmony
Shugaba, Abdulwarith
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  surname: Arujunan
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  surname: Sgourakis
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  givenname: Daren
  surname: Subar
  fullname: Subar, Daren
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Copyright The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com
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Snippet Aims The Enhanced Recovery Programme for Liver Surgery (ERPLS) has been shown to promote functional recovery and reduce hospital stay. However, its effect on...
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Liver
Multivariate analysis
Title SP6.1.11 ; The Effect of the Enhanced Recovery Programme for Liver Surgery on Long Term Survival
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