Enhanced Recovery Protocol: Is It Safe and Feasible After Open Conventional Liver Surgery?
DOI:
https://doi.org/10.64149/J.Ver.7.2.53-59Keywords:
Enhanced Recovery After Surgery (ERAS), open liver resection, perioperative outcomes, blood loss, surgical site infection, intra-abdominal collection, postoperative recovery.Abstract
Background: Open liver resections are essential for managing primary and secondary liver tumors but are often associated with significant morbidity, prolonged recovery, and high healthcare costs. Enhanced Recovery After Surgery (ERAS) protocols have demonstrated improved outcomes in various surgical fields, yet their application in open liver surgery remains under-investigated, particularly in low- and middle-income settings.
Objective: To assess the safety, feasibility, and clinical impact of implementing ERAS protocols in open conventional liver resections compared to traditional perioperative care.
Methods: A retrospective single-center study was conducted on 100 patients who underwent open liver resections at Tanta University Hospitals (2018–2023). Patients were divided into two groups: Group A (Pre-ERAS, n=50) and Group B (ERAS, n=50). ERAS protocols were implemented according to the ERAS Society Guidelines and involved structured interventions across the preoperative, intraoperative, and postoperative phases. Primary outcomes included operative blood loss, complications, and length of hospital stay.
Results: ERAS implementation led to significantly reduced blood loss (376 ± 140 ml vs 428 ± 160 ml, p=0.039), shorter hospital stay (4.68 ± 1.4 vs 6.24 ± 2.1 days, p<0.001), and lower wound infection rates (12% vs 30%, p=0.0041). However, a higher rate of intra-abdominal collections was observed in the ERAS group (30% vs 14%, p=0.07).
Conclusions: ERAS protocols are safe and feasible in open liver surgery and significantly improve recovery outcomes. Nevertheless, individualized drain management strategies may be necessary to mitigate the risk of intra-abdominal collections.
