ERAS PROTOCOLS IN ADRENAL SURGERY: THE EXPERIENCE OF A REFERTAL CENTER

AUTHORS:
G. Lelli (Latina, Italy) , A. Micalizzi (Latina, Italy) , A. Iossa (Latina, Italy) , A. Fassari (Rome, Italy) , A. Concistrè (Rome, Italy) , A. Circosta (Rome, Italy) , L. Petramala (Rome, Italy) , F. De Angelis (Latina, Italy) , C. Letizia (Rome, Italy) , G. Cavallaro (Latina, Italy)
Background:
To assess the impact of the Enhanced Recovery After Surgery (ERAS) pathway, this study was conducted in patients undergoing laparoscopic adrenalectomy (LA) for primary and secondary adrenal disease, in the reduction of the length of hospital stay and in return to daily activities.
Methods:
This study was carried out on 88 patients who underwent LA. A total of 44 patients formed the ERAS group. A total of 40 patients received conventional perioperative care and were assigned as the control group. Groups were compared in terms of patient's characteristics (sex, age, pre operative diagnosis, side of tumour, tumour size and co morbidities), post operative compliance (anaesthesia time, operative time, post operative stay, post operative numeric rating scale (NRS) score, analgesic assumption and return to daily activities) and post-operative complications.
Results:
No significant differences in anaesthesia time (P = 0.3) and operative time (P = 0.5) were reported. NRS score 24 h postoperatively was significantly lower in the ERAS group (P < 0.05). The analgesic assumption in post operative period in the ERAS group was lower (P < 0.05). ERAS protocol led to a significantly shorter length of post-operative stay (P < 0.05) and to return to daily activities (P < 0.05). No differences in perioperative complications were reported.
Conclusions:
ERAS protocol is safe and feasible and may improve the peri-operative outcome of patients undergoing LA. To investigate overall compliance with ERAS protocols and their impact on clinical outcomes, further studies are needed.