Methee Sutherasan MD*, Wipusit Taesombat MD*, Boonchoo Sirichindakul MD*, Bunthoon Nonthasoot MD*, Jade Supaphol MD*, Supanit Nivatwongs MD*
Affiliation : * Department of Surgery, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
Background : Enhanced recovery after surgery (ERAS) has been accepted as the program to improve the surgical outcomes.
This program has been increasingly utilized in liver resection.
Objective : To evaluate the outcomes of patients underwent liver resection by applying ERAS program.
Material and Method: All patients underwent liver resection between January 2007 and April 2011 at King Chulalongkorn
Memorial Hospital were included into the present study. Patients’ characteristics, preoperative factors, operative data,
postoperative care that correlated to ERAS components, and postoperative outcomes were recorded. Outcomes including
postoperative length of stay (LOS), intensive care unit (ICU) stay, complications, rate of reoperation, interventional treat-
ment, and mortality were compared between patients in ERAS group (applied ERAS components >4) and conventional group
(applied ERAS components <4).
Results : Three hundred forty seven patients were enrolled in present the study. There were 165 and 182 patients in ERAS and
conventional groups, respectively. When compared between these two groups, ERAS group had better postoperative LOS (7
days vs. 10 days; p = 0.0001), ICU stay (0 days vs. 1 days; p = 0.0001), reoperation rate (1.2% vs. 4.9%; p = 0.047) and
reintervention rate (15% vs. 27%; p = 0.005). There were no significant differences in complication rate (31% vs. 40%; p
= 0.096) and mortality rate (0.6% vs. 1.1%; p = 0.62).
Conclusion : ERAS program improves the surgical outcomes in patients who underwent liver resection.
Keywords : Enhanced recovery after surgery, Fast-track surgery, Liver resection
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