Introduction The high mortality and morbidity associated with resection for gastro-oesophageal malignancy has resulted in a conservative approach to the post-operative management of this patient group. In August 2009 an Enhanced Recovery After Surgery (ERAS) pathway tailored for patients undergoing resection for gastro-oesophageal malignancy was introduced. We aimed to assess the impact of this change in practice on standard clinical outcomes.
Methods We performed a retrospective review of two cohorts of patients undergoing resection for gastro-oesophageal malignancy before (08/08–07/09) and after (08/09–07/10) the implementation of the ERAS pathway. Data were collected on demographics, interventions, length of stay, morbidity and in hospital mortality.
Results There were 53 and 55 gastro-oesophageal resections undertaken in each year for malignant disease. The median length of stay for both gastric and oesophageal resection decreased from 15 to 11 days (p<0.001) following the implementation of the ERAS pathway. There was no increase in morbidity (gastric resection 23.1% vs 5.3% and oesophageal resection 25.9% vs 16.7%) or mortality (gastric resection no deaths and oesophageal resection 1.8% vs 3.6%) associated with the changes. There was a significant decrease in the number of oral contrast studies used following oesophageal resection with a reduction from 21 (77.8%) in 2008–2009 to 6 (16.7%) in 2009–2010 (χ2, p<0.0001).
Conclusion The introduction of an enhanced recovery programme following gastro-oesophageal surgery resulted in a significant decrease in length of median patient stay in hospital without a significant increase in associated morbidity and mortality.
Competing interests None declared.
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