ERAS protocol safe, shortens postoperative stay in elderly gastric cancer patients

Among older adults undergoing gastrectomy for gastric cancer, employing the Enhanced Recovery After Surgery (ERAS) protocol leads to a shorter postoperative hospital stay without introducing new safety signals, a recent study has found.

The study included 100 eligible patients, of whom 50 (mean age 72.3 years, 38 men) underwent gastrectomy with the ERAS protocol, while 50 (mean age 72.7 years, 36 men) did not. Study outcomes were postoperative complications, hospital stay, readmission, and hospitalization expenses, compared between groups.

Complications defined as episodes with Clavien-Dindo grade ≥2 arose in 16 percent of the ERAS group and 18 percent of the conventional gastrectomy group. The difference between the groups did not reach statistical significance (p=0.79).

Pneumonia was the most common adverse event, occurring in three and four patients in the ERAS and conventional gastrectomy groups, respectively. One episode of Clavien-Dindo grade III anastomotic leakage was reported in each arm.

In terms of clinical outcomes, ERAS patients saw a significantly shorter postoperative hospital stay (p=0.0001). Cost of hospitalization was also lower in the ERAS group, though not significantly so (p=0.12). No patient deaths were reported.

“Although there was no statistical significance for the cost of hospitalization, the absolute value of cost was lower in the ERAS group,” the researchers said. “This outcome had practical significance [and] reminded us that the ERAS protocol would limit the cost increase.”