eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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1/2022
vol. 17
 
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Urology
abstract:
Randomized controlled trial

Enhanced recovery after surgery in patients undergoing laparoscopic partial nephrectomy. Results from a real-world randomized controlled trial

Xiaoqiang Xue
1
,
Dong Wang
1
,
Zhigang Ji
1
,
Yi Xie
1

1.
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Videosurgery Miniinv 2022; 17 (1): 116–126
Online publish date: 2021/07/30
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Introduction
Enhanced recovery after surgery (ERAS) is a set of perioperative interventions to alleviate patients’ stress response and complications, and to promote rehabilitation. Data on its implementation in renal cell carcinoma treated by laparoscopic partial nephrectomy are lacking.

Aim
To evaluate the prospect of application of ERAS in laparoscopic partial nephrectomy based on real-world data.

Material and methods
Sixty patients with T1a staging renal cell carcinoma (RCC) were randomly classified as the ERAS group (31 patients) or traditional treatment group (29 patients). Relevant endpoints including postoperative length of stay, ambulation, fart, oral intake, pain at different movement and time points, postoperative nausea and vomiting, complications as well as hospitalization expenses in the two groups were analyzed and compared.

Results
The ERAS optimization group presented a shorter time of first-time ambulation (p = 0.008), less pain at rest and ankle movement (p < 0.05), and less feeling of nausea 2 and 4 h after surgery (p = 0.006 and 0.027, respectively). (Although the differences in hospitalization expenses, postoperative length of stay, and complications were not reached in our study (p > 0.05), they were significantly lower than those reported in other literature.

Conclusions
The idea of ERAS has had an imperceptible influence on clinical strategy making for over 20 years. This study shows that it could alleviate postoperative pain both at rest and movement, enable earlier walking, and reduce postoperative nausea in patients who have undergone laparoscopic partial nephrectomy. However, its efficacy is sometimes over-extended when compared to extreme conserative. Also, specific ERAS protocols and large-sample clinical trials are needed.

keywords:

enhanced recovery after surgery, laparoscopic partial nephrectomy, renal cell carcinoma, randomized controlled trial

  
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