Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications
Abstract Enhanced Recovery after Surgery (ERAS) is a multimodal approach to improve surgical outcome and has been implemented in many fields of surgery in an international scale. The aim of this study was to evaluate the effect of the Enhanced Recovery after Surgery (ERAS) society recommendations in...
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Nature Portfolio
2025-01-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-86808-z |
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| author | Robert Oehring Eriselda Keshi Karl-Herbert Hillebrandt Pia F. Koch Matthäus Felsenstein Simon Moosburner Wenzel Schöning Nathanael Raschzok Johann Pratschke Jens Neudecker Felix Krenzien |
| author_facet | Robert Oehring Eriselda Keshi Karl-Herbert Hillebrandt Pia F. Koch Matthäus Felsenstein Simon Moosburner Wenzel Schöning Nathanael Raschzok Johann Pratschke Jens Neudecker Felix Krenzien |
| author_sort | Robert Oehring |
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| description | Abstract Enhanced Recovery after Surgery (ERAS) is a multimodal approach to improve surgical outcome and has been implemented in many fields of surgery in an international scale. The aim of this study was to evaluate the effect of the Enhanced Recovery after Surgery (ERAS) society recommendations in liver surgery and the impact on general and surgery-related complications. 1049 patients who underwent liver surgery from July 2018 to October 2023 were included. The ERAS program strictly followed the official ERAS society recommendations. As a control group (Non-ERAS) 90 patients were treated according to the clinic standard, while 959 patients were treated according within the ERAS measures. After propensity score (PSM) matching 87 Non-ERAS and 258 ERAS patients were analyzed by complications and cumulative sum analysis (CUSUM). ERAS implementation resulted in a significant decrease in general complications (control 27.6% vs. ERAS 16.3%, p = 0.033), largely attributed to a reduction in infection-related complications (control 20.7% vs. ERAS 9.7%, p = 0.007). When examining surgery-related complications no significant disparities were observed (control 17.2% vs. ERAS 17.1%, p = 0.968). The CUSUM analysis of general and non-surgical complications showed that the full effect of the ERAS program only became apparent after several years. Moreover, adherence increased over time consecutively from 62.5 to 72.5% in 4 years. The ERAS society recommendations for liver surgery reduced general complications but did not have any effect on surgery related complications. The effect of the ERAS program progressively improved over the years, highlighting the need for continuous effort to maintain and further enhance outcomes. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-003b96e2e8c5402b9f1c1a926da3883d2025-02-02T12:16:54ZengNature PortfolioScientific Reports2045-23222025-01-011511910.1038/s41598-025-86808-zEnhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complicationsRobert Oehring0Eriselda Keshi1Karl-Herbert Hillebrandt2Pia F. Koch3Matthäus Felsenstein4Simon Moosburner5Wenzel Schöning6Nathanael Raschzok7Johann Pratschke8Jens Neudecker9Felix Krenzien10Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinDepartment of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin, corporate member of Freie Universität Berlin, Humboldt-Universität zu BerlinAbstract Enhanced Recovery after Surgery (ERAS) is a multimodal approach to improve surgical outcome and has been implemented in many fields of surgery in an international scale. The aim of this study was to evaluate the effect of the Enhanced Recovery after Surgery (ERAS) society recommendations in liver surgery and the impact on general and surgery-related complications. 1049 patients who underwent liver surgery from July 2018 to October 2023 were included. The ERAS program strictly followed the official ERAS society recommendations. As a control group (Non-ERAS) 90 patients were treated according to the clinic standard, while 959 patients were treated according within the ERAS measures. After propensity score (PSM) matching 87 Non-ERAS and 258 ERAS patients were analyzed by complications and cumulative sum analysis (CUSUM). ERAS implementation resulted in a significant decrease in general complications (control 27.6% vs. ERAS 16.3%, p = 0.033), largely attributed to a reduction in infection-related complications (control 20.7% vs. ERAS 9.7%, p = 0.007). When examining surgery-related complications no significant disparities were observed (control 17.2% vs. ERAS 17.1%, p = 0.968). The CUSUM analysis of general and non-surgical complications showed that the full effect of the ERAS program only became apparent after several years. Moreover, adherence increased over time consecutively from 62.5 to 72.5% in 4 years. The ERAS society recommendations for liver surgery reduced general complications but did not have any effect on surgery related complications. The effect of the ERAS program progressively improved over the years, highlighting the need for continuous effort to maintain and further enhance outcomes.https://doi.org/10.1038/s41598-025-86808-zEnhanced recovery after surgery (ERAS)Liver surgeryComplications |
| spellingShingle | Robert Oehring Eriselda Keshi Karl-Herbert Hillebrandt Pia F. Koch Matthäus Felsenstein Simon Moosburner Wenzel Schöning Nathanael Raschzok Johann Pratschke Jens Neudecker Felix Krenzien Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications Scientific Reports Enhanced recovery after surgery (ERAS) Liver surgery Complications |
| title | Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications |
| title_full | Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications |
| title_fullStr | Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications |
| title_full_unstemmed | Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications |
| title_short | Enhanced recovery after surgery society’s recommendations for liver surgery reduces non surgical complications |
| title_sort | enhanced recovery after surgery society s recommendations for liver surgery reduces non surgical complications |
| topic | Enhanced recovery after surgery (ERAS) Liver surgery Complications |
| url | https://doi.org/10.1038/s41598-025-86808-z |
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