The Effect of the Enhanced Recovery Programme on long term survival following liver resection for colorectal liver metastases

Lambert, Joel and Mair, Thomas and Arunjunan, Kalaiyarasi and Shugaba, Abdul and Uwadiae, Harmony and Livesey, Anne and Ahmad, Rami and Sgourakis, Georgios and Gaffney, Christopher and Subar, Daren (2023) The Effect of the Enhanced Recovery Programme on long term survival following liver resection for colorectal liver metastases. Langenbeck's Archives of Surgery, 408 (1): 239. ISSN 1435-2443

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Abstract

BACKGROUND: Enhanced recovery programmes are associated with improved short-term outcomes following liver surgery. The impact of enhanced recovery programmes on medium- and long-term outcomes is incompletely understood. This study aimed to assess the impact of an enhanced recovery programme on long-term survival in patients undergoing surgery for colorectal liver metastases. METHODS: At a tertiary hepatobiliary centre, we analysed short-, medium- and long-term outcomes in consecutive patients undergoing liver resection for colorectal liver metastases. A five-year retrospective review was carried out comparing the enhanced recovery programme to standard care. RESULTS: A total of 172 patients were included in the analysis: 87 on standard care and 85 on an enhanced recovery programme. Open surgery was performed in 122 patients: 74 (85.1%) and 48 (56.5%) patients in the standard care and enhanced recovery programme, respectively (p < 0.001). There was a significant reduction in the median (IQR) length of hospital stay in the enhanced recovery programme compared with standard care (7 (5) days vs. 8 (3) days, p = 0.0009). There was no significant difference in survival between standard care and the Enhanced Recovery Programme at one (p = 0.818), three (p = 0.203), and five years (p = 0.247). CONCLUSION: An enhanced recovery programme was associated with a reduced length of hospital stay. There was no effect on the one-, three- and five-year survival.