The "Weekday Effect" on Enhanced Recovery after Surgery Protocol for Gastrectomy.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2023-01-01 DOI:10.1159/000531022

Jacopo Weindelmayer, Valentina Mengardo, Lorena Torroni, Maria Clelia Gervasi, Selma Hetoja, Carlo Alberto De Pasqual, Davide Simion, Simone Giacopuzzi

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引用次数: 0

Abstract

Introduction: While enhanced recovery after surgery (ERAS) protocol demonstrated to improve outcomes after gastrectomy, some papers evidenced a detrimental effect on postoperative morbidity related to the "weekday effect." We aimed to understand whether the day of gastrectomy could affect postoperative outcomes and compliance with ERAS items.

Methods: We included all patients that underwent gastrectomy for cancer between January 2017 and September 2021. Cohort was divided considering the day of surgery: Early group (Monday-Wednesday) and Late group (Thursday-Friday). Compliance with protocol and postoperative outcomes were compared.

Results: Two hundred twenty-seven patients were included in Early group, while 154 were in Late group. The groups were comparable in preoperative characteristics. No significant difference in pre/intraoperative and postoperative ERAS items' compliance was apparent between Early and Late groups, with most items exceeding the 70% threshold. Median length of stay was 6.5 days and 6 days in Early and Late groups (p = 0.616), respectively. Morbidity was 50% in both groups, with severe complications that occurred in 13% of Early patients and 15% of Late patients. Ninety-day mortality was 2%, and it was similar between the two groups.

Conclusions: In a center with a standardized ERAS protocol, the weekday of gastrectomy has no significant impact on the success of each ERAS item and on postoperative surgical and oncological outcomes.

查看原文本刊更多论文

“工作日效应”对胃切除术后增强恢复的影响。

导论:虽然ERAS方案被证明可以改善胃切除术后的预后，但一些论文证明了与“工作日效应”相关的对术后发病率的不利影响。我们的目的是了解胃切除术的日期是否会影响术后结果和ERAS项目的依从性。方法:我们纳入了2017年1月至2021年9月期间因癌症接受胃切除术的所有患者。根据手术日期将队列分为早组(周一-周三)和晚组(周四-周五)。比较方案依从性和术后结果。结果:早期组227例，晚期组154例。两组术前特征具有可比性。早期组和晚期组术前/术中及术后ERAS项目的依从性无明显差异，多数项目超过70%阈值。早期组和晚期组的中位住院时间分别为6.5 d和6 d (p = 0.616)。两组的发病率均为50%，早期和晚期患者中分别有13%和15%出现严重并发症。90天死亡率为2%，两组之间相似。结论:在采用标准化ERAS方案的中心，胃切除术的工作日对ERAS各项目的成功及术后手术和肿瘤预后无显著影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.