Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study
Objective: The aim of this study is to evaluate the implementation of the elements of enhanced recovery (ERAS) protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic ovarian cancer. ERAS protocols have shown improvement in the peri...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-12-01
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| Series: | Gynecologic Oncology Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578924002157 |
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| author | Anastasios Pandraklakis Chrysoula Liakou MariaClelia La Russa Rocio Ochoa-Ferraro Adam Stearns Nikolaos Burbos |
| author_facet | Anastasios Pandraklakis Chrysoula Liakou MariaClelia La Russa Rocio Ochoa-Ferraro Adam Stearns Nikolaos Burbos |
| author_sort | Anastasios Pandraklakis |
| collection | DOAJ |
| description | Objective: The aim of this study is to evaluate the implementation of the elements of enhanced recovery (ERAS) protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic ovarian cancer. ERAS protocols have shown improvement in the perioperative outcomes of patients who underwent cytoreductive surgery for metastatic ovarian cancer by reducing the length of stay as well as the postoperative complications and by improving patients’ postoperative experience. Methods: This is a feasibility study involving retrospective analysis from (31) patients who underwent cytoreductive surgery and HIPEC versus (35) a control group that underwent cytoreductive surgery only, prior to the introduction of the HIPEC programme for metastatic ovarian cancer. All patients had undergone neoadjuvant chemotherapy prior to surgery. We compared the compliance for each element of the ERAS protocol between the two study groups. Results: We analyzed data from 66 patients, 31 in HIPEC group and 35 in the control goup. We found no significant difference in the patients’ characteristics between the two groups and there were no differences in the implementation of 8 elements of the ERAS protocols (100 % for both groups). The use of nasogastric tube was more frequently observed in patients undergoing surgery and HIPEC compared to those undergoing surgery alone (42 % vs 0 %, respectively; p < 0.001). The number of patients who were mobilized on the first postoperative day was higher in the group undergoing surgery and HIPEC (87.1 % vs 57.1 %, respectively; p = 0.007), however there was no significant difference in the percentage of patients that had early removal of the urinary catheter (p = 0.12), nor in the percentage of patients that received early feeding (p = 0.18). Finally, there were no statistically significant differences in the complication rates, the length of hospital stay and the re-admission rates between the two groups. Conclusion: Enhanced recovery protocols can be implemented safely in patients undergoing cytoreductive surgery and HIPEC for ovarian cancer. |
| format | Article |
| id | doaj-art-2b066f2ff44c4cf1bddccd2e8e8f5ac8 |
| institution | OA Journals |
| issn | 2352-5789 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-2b066f2ff44c4cf1bddccd2e8e8f5ac82025-08-20T02:37:42ZengElsevierGynecologic Oncology Reports2352-57892024-12-015610153610.1016/j.gore.2024.101536Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility studyAnastasios Pandraklakis0Chrysoula Liakou1MariaClelia La Russa2Rocio Ochoa-Ferraro3Adam Stearns4Nikolaos Burbos5Department of Gynaecology and Gynaecological Oncology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UK; Corresponding author.Department of Gynaecology and Gynaecological Oncology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UKDepartment of Gynaecology and Gynaecological Oncology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UKDepartment of Anesthesia, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UKDepartment of Surgery, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UKDepartment of Gynaecology and Gynaecological Oncology, Norfolk and Norwich University Hospital, Norwich NR4 7UY, UKObjective: The aim of this study is to evaluate the implementation of the elements of enhanced recovery (ERAS) protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for metastatic ovarian cancer. ERAS protocols have shown improvement in the perioperative outcomes of patients who underwent cytoreductive surgery for metastatic ovarian cancer by reducing the length of stay as well as the postoperative complications and by improving patients’ postoperative experience. Methods: This is a feasibility study involving retrospective analysis from (31) patients who underwent cytoreductive surgery and HIPEC versus (35) a control group that underwent cytoreductive surgery only, prior to the introduction of the HIPEC programme for metastatic ovarian cancer. All patients had undergone neoadjuvant chemotherapy prior to surgery. We compared the compliance for each element of the ERAS protocol between the two study groups. Results: We analyzed data from 66 patients, 31 in HIPEC group and 35 in the control goup. We found no significant difference in the patients’ characteristics between the two groups and there were no differences in the implementation of 8 elements of the ERAS protocols (100 % for both groups). The use of nasogastric tube was more frequently observed in patients undergoing surgery and HIPEC compared to those undergoing surgery alone (42 % vs 0 %, respectively; p < 0.001). The number of patients who were mobilized on the first postoperative day was higher in the group undergoing surgery and HIPEC (87.1 % vs 57.1 %, respectively; p = 0.007), however there was no significant difference in the percentage of patients that had early removal of the urinary catheter (p = 0.12), nor in the percentage of patients that received early feeding (p = 0.18). Finally, there were no statistically significant differences in the complication rates, the length of hospital stay and the re-admission rates between the two groups. Conclusion: Enhanced recovery protocols can be implemented safely in patients undergoing cytoreductive surgery and HIPEC for ovarian cancer.http://www.sciencedirect.com/science/article/pii/S2352578924002157 |
| spellingShingle | Anastasios Pandraklakis Chrysoula Liakou MariaClelia La Russa Rocio Ochoa-Ferraro Adam Stearns Nikolaos Burbos Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study Gynecologic Oncology Reports |
| title | Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study |
| title_full | Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study |
| title_fullStr | Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study |
| title_full_unstemmed | Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study |
| title_short | Implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy. A feasibility study |
| title_sort | implementation of enhanced recovery protocols in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for metastatic ovarian cancer following neoadjuvant chemotherapy a feasibility study |
| url | http://www.sciencedirect.com/science/article/pii/S2352578924002157 |
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