Jian Zhao1, Jiawei Hu1, Zhiwei Jiang1, Gang Wang1, Jiang Liu1, Haifeng Wang1, Peng Fang1, Xinxin Liu2, Jian Wang3, Jieshou Li1. 1. 1 Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University , Nanjing, China . 2. 2 Department of Gastrointestinal Surgery, Clinical Medical School, Northern Jiangsu People's Hospital, Yangzhou University , Yangzhou, China . 3. 3 Department of Gastrointestinal Surgery, Suqian People's Hospital , Suqian, China .
Abstract
AIMS: To evaluate the safety and outcome of discharge within 72 hours of a robotic gastrectomy together with enhanced recovery after surgery (ERAS) programs. MATERIALS AND METHODS: In total, 108 consecutive patients received elective robotic gastrectomy for gastric cancer from April 2017 to September 2017. All patients attended ERAS programs, which do not routinely use nasogastric tubes but include early feeding, early ambulation, and standard discharge criteria, among other items. RESULTS: The mean age was 58.7 ± 10.4 years old, and the mean body mass index was 22.9 ± 2.8 kg/m2. The mean postoperative length of hospital stay was 5.6 ± 8.0 days, and 13 patients (12.0%) exhibited a complication within 30 days with no mortality. A total of 38 patients (35.2%) were discharged within 72 hours of surgery. Patients were grouped based on being discharged within or after 72 hours. The rate of complications was significantly lower in patients discharged within 72 hours than patients discharged after 72 hours (1/38, 2.6% versus 12/70, 17.1%, P = .028). Although patients discharged within 72 hours showed lower readmission numbers, this difference was not statistically significant (1/38, 2.6% versus 8/70, 11.4%, P = .116). One month after surgery, loss of weight, loss of total protein, loss of albumin, and loss of prealbumin in patients discharged within 72 hours were less than those of patients discharged after 72 hours. CONCLUSION: Complication and readmission rates are low in patients discharged within 72 hours of robotic gastrectomy when ERAS programs and standard discharge criteria are used.
AIMS: To evaluate the safety and outcome of discharge within 72 hours of a robotic gastrectomy together with enhanced recovery after surgery (ERAS) programs. MATERIALS AND METHODS: In total, 108 consecutive patients received elective robotic gastrectomy for gastric cancer from April 2017 to September 2017. All patients attended ERAS programs, which do not routinely use nasogastric tubes but include early feeding, early ambulation, and standard discharge criteria, among other items. RESULTS: The mean age was 58.7 ± 10.4 years old, and the mean body mass index was 22.9 ± 2.8 kg/m2. The mean postoperative length of hospital stay was 5.6 ± 8.0 days, and 13 patients (12.0%) exhibited a complication within 30 days with no mortality. A total of 38 patients (35.2%) were discharged within 72 hours of surgery. Patients were grouped based on being discharged within or after 72 hours. The rate of complications was significantly lower in patients discharged within 72 hours than patients discharged after 72 hours (1/38, 2.6% versus 12/70, 17.1%, P = .028). Although patients discharged within 72 hours showed lower readmission numbers, this difference was not statistically significant (1/38, 2.6% versus 8/70, 11.4%, P = .116). One month after surgery, loss of weight, loss of total protein, loss of albumin, and loss of prealbumin in patients discharged within 72 hours were less than those of patients discharged after 72 hours. CONCLUSION: Complication and readmission rates are low in patients discharged within 72 hours of robotic gastrectomy when ERAS programs and standard discharge criteria are used.
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Keywords:
enhanced recovery after surgery; gastric cancer; length of stay; nutritional status; robotic gastrectomy