Enhanced Recovery After Surgery Protocol Optimizes Results and Cost of Laparoscopic Radical Nephrectomy

Siming Chen; Zhiwen He; Shijie Yao; Kangping Xiong; Jiageng Shi; Gang Wang; Kaiyu Qian; Xinghuan Wang

doi:10.3389/fonc.2022.840363

Enhanced Recovery After Surgery Protocol Optimizes Results and Cost of Laparoscopic Radical Nephrectomy

Front Oncol. 2022 Apr 4:12:840363. doi: 10.3389/fonc.2022.840363. eCollection 2022.

Authors

Siming Chen¹, Zhiwen He¹, Shijie Yao², Kangping Xiong¹, Jiageng Shi¹, Gang Wang^{3

4

5}, Kaiyu Qian^{3

4

5}, Xinghuan Wang^{1

5

6}

Affiliations

¹ Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China.
² Department of Gynecological Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China.
³ Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, China.
⁴ Laboratory of Precision Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
⁵ Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China.
⁶ Department of Biological Repositories, Frontier Science Center for Immunology and Metabolism, Medical Research Institute, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China.

Abstract

Purpose: To assess the impact of enhanced recovery after surgery (ERAS) protocols in laparoscopic radical nephrectomy (LRN).

Methods: The clinical data of 89 patients underwent LRN in Zhongnan Hospital of Wuhan University from February 2019 to September 2021 were collected (40 in the ERAS group and 49 in the pre-ERAS group). The clinical characteristics, prognosis, and length of hospital stay (LOS) were compared between the two groups using t test, Mann-Whitney test, and chi-square test.

Results: Total LOS and postoperative LOS were significantly shorter in ERAS group than in pre-ERAS group [15.0 (13.5-19.5) vs. 12.0 (10.0-14.0), P < 0.001; 8.0 (7.0-10.0) vs. 7.0 (5.0-8.8), P = 0.001]. Compared with the pre-ERAS group, the hospitalization expenses of the ERAS group were also lower (P = 0.023). In addition, the incidence of postoperative complications in the ERAS group also decreased (P = 0.054).

Conclusions: ERAS protocol in LRN could help accelerate the recovery of patients and is worthy of clinical promotion.

Keywords: enhanced recovery after surgery; laparoscopic radical nephrectomy; length of hospital stay; postoperative complications; renal cell carcinoma.