LiDCOrapid as part of an enhanced recovery program (ERP) Randomised ERP vs. standard care showed reduced length of stay by 3 days and complications reduced from 27% to 7%.
Enhanced recovery programs (ERPs) have been shown to reduce the length of hospital stay (LOS) and complications in colorectal surgery. Whether ERPs have the same benefits in open liver resection surgery is unclear, and randomized clinical trials are lacking.
Consecutive patients scheduled for open liver resection were randomized to an ERP group or standard care. Primary endpoints were time until medically fit for discharge (MFD) and LOS. Secondary endpoints were
The analysis included 46 patients in the ERP group and 45 in the standard care group. Median MFD time was reduced in the ERP group (3 days versus 6 days with standard care; P < 0·001), as was LOS (4 days versus 7 days; P < 0·001). The ERP significantly reduced the rate of medical complications (7 versus 27 percent; P = 0·020), but not surgical complications (15 versus 11 percent; P = 0·612), readmissions (4 versus 0 percent; P = 0·153) or mortality (both 2 per cent; P = 0·987). QoL over 28 days was significantly better in the ERP group (P = 0·002). There was no difference in patient satisfaction.
ERPs for open liver resection surgery
Jones C, Kelliher L, Dickinson M, Riga A, Worthington T, Scott M J, Vandrevala T, Fry C H, Karanjia N and