Enhanced recovery after surgery decreases intestinal recovery time and pain intensity in patients undergoing curative gastrectomy

Figures & data

Table 1 Comparison of clinicopathologic characteristics between the ERAS and CC groups

Characteristics	ERAS group (n=102)	CC group (n=264)	P-value
Age			0.733
≤60	54	145
>60	48	119
Mean	58	58
Median	57	56
Years	34–79	37–79
Gender			0.074
Male	62	133
Female	40	131
BMI (kg/m^2)	22.18±3.55	21.81±3.20	0.338
NRS 2002 score			0.866
1	40	101
2	62	163
ASA score			0.107
I	58	74
II	44	90
TNM classification			0.837
I	39	105
II	32	87
III	31	72

Abbreviations: ERAS, enhanced recovery after surgery; CC, conventional care; ASA, American Society of Anesthesiologists; BMI, body mass index; NRS, nutritional risk screening; TNM, tumor node metastasis.

Table 2 Comparison of surgical procedures and outcomes between the ERAS and CC groups

Characteristics	ERAS group (n=102)	CC group (n=264)	P-value
Surgical approach
Laparoscopic assisted	53	128	0.551
Open	49	136
Type of operation
Distal gastrectomy	58	146	0.788
Total gastrectomy	44	118
Type of reconstruction
Billroth I	27	55
Billroth II	31	91	0.484
Roux-en-Y	44	118
Operation time (minutes)	186.00±43.03	169.20±56.54	0.007a
Blood loss	142.6±45.27	147.3±41.05	0.341

Note:

a Statistically significant (P<0.05).

Abbreviations: ERAS, enhanced recovery after surgery; CC, conventional care.

Table 3 Comparison of postoperative clinical outcomes between ERAS and CC groups

Characteristics	ERAS group (n=102)	CC group (n=264)	P-value
Time to first flatus (h)	3.26±0.64	4.68±0.49	<0.001a
VAS POD 1	2.33±0.98	4.17±0.99	<0.001a
VAS POD 2	1.06±0.63	2.35±0.71	<0.001a
Number of additional doses of analgesics	2(1.96%)	20(7.58%)	0.043a
Postoperative hospital stays (days)	6.66±3.36	9.02±2.61	<0.001a
Postoperative death	0	0
Readmissions (n)	4 (3.92%)	14 (5.30%)	0.584

Notes: The values given are number of patients unless indicated otherwise.

a Statistically significant (P<0.05).

Abbreviations: ERAS, enhanced recovery after surgery; CC, conventional care; POD, postoperative day; VAS, visual analog scale.

Table 4 Comparison of laboratory findings between the ERAS and CC groups

Characteristics	ERAS group (n=102)	CC group (n=264)	P-value
White blood cell count
Before surgery	6.36±1.58	6.58±1.48	0.223
POD 1	12.03±1.46	12.44±1.62	0.025a
POD 3	10.30±2.23	12.61±2.37	<0.01a
Albumin (g/L)
Before surgery	40.05±2.54	39.82±2.58	0.441
POD 1	28.63±2.27	26.11±1.82	<0.01a
POD 3	27.67±2.76	25.63±2.05	<0.01a
Lymphocyte count
Before surgery	2.52±0.45	2.44±0.49	0.180
POD 1	1.83±0.53	1.35±0.59	<0.01a
POD 3	2.20±0.73	1.50±0.72	<0.01a
CRP (mg/dL)
Before surgery	5.05±0.51	5.11±0.49	0.289
POD 1	22.07±6.70	23.96±6.76	0.017a
POD 3	57.77±15.88	61.50±16.30	0.049a
Postoperative hospital stays (days)	5.56±0.50	7.94±0.75	<0.001a

Note:

a Statistically significant (P<0.05).

Abbreviations: ERAS, enhanced recovery after surgery; CC, conventional care; CRP, C-reactive protein; POD, postoperative day.

Table 5 Comparison of postoperative complications between the ERAS group and CC groups

Characteristics	ERAS group (n=102)	CC group (n=264)	P-value
Postoperative complications	15 (14.71%)	40 (15.15%)	0.915
Anastomotic leakage	2 (1.96%)	6 (2.27%)	0.855
Intra-abdominal infection	1 (0.98%)	6 (2.27%)	0.418
Surgical-incision infection	2 (1.96%)	10 (3.79%)	0.379
Incision fat liquefaction	5 (4.90%)	13 (4.92%)	0.993
Gastroparesis	5 (4.90%)	4 (1.52%)	0.061

Abbreviations: ERAS, enhanced recovery after surgery; CC, conventional care.