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ANZMOSS - ANZGOSA 2020 Virtual Conference
ANZMOSS – ANZGOSA 2020 Virtual Conference
ANZMOSS - ANZGOSA 2020 Virtual Conference

Enhanced Recovery After Surgery (ERAS) protocol following oesophagectomy: Outcomes in an Australian tertiary referral cancer centre.

Surgical resection remains as the only curative option for oesophagogastric cancers but carries a significant morbidity and mortality. Enhanced Recovery After Surgery (ERAS) protocols adopted by many high volume resectional centres across the world have demonstrated reductions in peri-operative complications and length of stay. To date however, there has been a paucity of literature in the application of ERAS in an Australian setting and its impact on peri-operative outcomes.  
An ERAS protocol was developed at Alfred Hospital for oesophageal cancer resections and has been routinely used for patients since July 2017. Patient demographics and peri-operative data was collected and recorded in a local cancer database and compared to resections prior to July 2017. 
A total of 135 patients underwent oesophagectomy between July 2014 and July 2019, 86 patients in the control group (Pre-ERAS), and 49 in the interventional group. The length of stay for patients without complication reduced by 2.5 days (14.5 days vs. 12 days, p = 0.013) after implementation of the ERAS protocol. The number of patients requiring blood transfusions reduced (32.9% vs. 12.5%, p = 0.01). All respiratory complications reduced in the ERAS patient group (41.9% vs. 36.7%, p = 0.559). The rate of clinically apparent atelectasis (14% vs. 4.1%, p = 0.07) and respiratory failure (defined as those requiring supplemental oxygen therapy, 41.9% vs. 34.7%, p = 0.412) reduced. There was no adverse change in the anastomotic leak rate after the implementation of ERAS (10.5% vs., 10.2%, p = 0.962) and no increase in the overall complication rate.  
The use of an ERAS protocol in patients undergoing oesophagogastric resections in a comparatively high volume resectional centre in Australia, results in significant reduction in postoperative complications and inpatient length of stay, in keeping with previously published international published data. 
Professor Wendy A. Brown - Alfred Health, Monash University , Paul Burton - Alfred Health, Monash University , Kalai Shaw - Alfred Health , Richard Chen - Alfred Health , Prem Chana - Alfred Health, Monash University , and Matthew AR Stokes - Alfred Health
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