Objective

Data are sparse regarding the multidisciplinary perioperative enhanced recovery after surgery protocol (E-P) for thoracic esophageal cancer surgery that was newly used at another institution. Therefore, this study aimed to retrospectively evaluate the effectiveness and safety of the protocol.

Methods

We enrolled 101 patients who underwent transthoracic esophagectomy for E-P at the Shizuoka Cancer Center Hospital (SCC). The outcomes obtained at the SCC were compared with the outcomes of 140 patients treated with E-P at the Saitama Medical University International Medical Center (SMU). At the SMU, we compared the results before and after the introduction of E-P.

Results

The rates of morbidity, pulmonary complications, and postoperative pneumonia were 44%, 31%, and 6.9% at the SCC and 44%, 27%, and 6.5% at the SMU (P = 0.91, 0.55, and 0.88, respectively). The mean time to walk was 1.1 and 1.5 days at the SCC and SMU, respectively (P < 0.001). The median length of hospital stay was longer at the SMU than at the SCC (24.0 versus 20.8 days; P = 0.004). In the comparative study before and after the introduction of E-P, the rate of postoperative pneumonia was 16% in the conventional management group and 6.5% in the E-P group (P = 0.02).

Conclusion

Postoperative pneumonia was reduced before and after introduction of E-P. As similar short-term postoperative outcomes were promising (except for the time to walk and postoperative hospital stay), the same E-P that was safely performed at the SMU can be implemented as a standard practice.

中文翻译：

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新型多学科围手术期促进胸段食管癌术后恢复方案的有效性和安全性

客观的

关于在另一家机构新使用的胸段食管癌手术的多学科围手术期促进术后恢复方案 (EP) 的数据很少。因此，本研究旨在回顾性评估该方案的有效性和安全性。

方法

我们招募了 101 名在静冈癌症中心医院 (SCC) 接受经胸食管切除术治疗 EP 的患者。在 SCC 获得的结果与在埼玉医科大学国际医疗中心 (SMU) 接受 EP 治疗的 140 名患者的结果进行了比较。在 SMU，我们比较了引入 EP 前后的结果。

结果

SCC 的发病率、肺部并发症和术后肺炎的发生率分别为 44%、31% 和 6.9%，而 SMU 的发病率分别为 44%、27% 和 6.5%（P 分别为 0.91、0.55 和 0.88）。SCC 和 SMU 的平均步行时间分别为 1.1 天和 1.5 天（P  < 0.001）。SMU 的中位住院时间长于 SCC（24.0 天对 20.8 天；P  = 0.004）。在 EP 引入前后的对比研究中，常规治疗组术后肺炎发生率为 16%，EP 组为 6.5%（P  =0.02）。

结论

术后肺炎在引入 EP 前后有所减少。由于类似的短期术后结果是有希望的（除了步行时间和术后住院时间），在 SMU 安全执行的相同 EP 可以作为标准实践实施。