Safety and efficacy of fast-track surgery in laparoscopic distal gastrectomy for gastric cancer: A randomized clinical trial

Jong Won Kim, Whan Sik Kim, Jae Ho Cheong, Woo Jin Hyung, Seung Ho Choi, Sung Hoon Noh

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Background Fast-track surgery has been shown to enhance postoperative recovery in several surgical fields. This study aimed to evaluate the safety and efficacy of fasttrack surgery in laparoscopic distal gastrectomy. Methods The present study was designed as a singlecenter, randomized, unblinded, parallel-group trial. Patients were eligible if they had gastric cancer for which laparoscopic distal gastrectomy was indicated. The fasttrack surgery protocol included intensive preoperative education, a short duration of fasting, a preoperative carbohydrate load, early postoperative ambulation, early feeding, and sufficient pain control using local anesthetics perfused via a local anesthesia pump device, with limited use of opioids. The primary endpoint was the duration of possible and actual postoperative hospital stay. Results We randomized 47 patients into a fast-track group (n = 22) and a conventional pathway group (n = 22), with three patients withdrawn. The possible and actual postoperative hospital stays were shorter in the fasttrack group than in the conventional group (4.68 ± 0.65 vs. 7.05 ± 0.65; P <0.001 and 5.36 ± 1.46 vs. 7.95 ± 1.98; P <0.001). The time to first flatus and pain intensity were not different between groups; however, a greater frequency of additional pain control was needed in the conventional group (3.64 ± 3.66 vs. 1.64 ± 1.33; P = 0.023). The fast-track group was superior to the conventional group in several factors of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, including: fatigue, appetite loss, financial problems, and anxiety. The complication and readmission rates were similar between groups. Conclusions Fast-track surgery could enhance postoperative recovery, improve immediate postoperative quality of life, and be safely applied in laparoscopic distal gastrectomy.

Original languageEnglish
Pages (from-to)2879-2887
Number of pages9
JournalWorld Journal of Surgery
Volume36
Issue number12
DOIs
Publication statusPublished - 2012 Dec

Fingerprint

Gastrectomy
Laparoscopy
Stomach Neoplasms
Randomized Controlled Trials
Safety
Pain
Length of Stay
Quality of Life
Flatulence
Early Ambulation
Appetite
Local Anesthesia
Local Anesthetics
Opioid Analgesics
Fatigue
Fasting
Anxiety
Carbohydrates
Organizations
Education

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kim, Jong Won ; Kim, Whan Sik ; Cheong, Jae Ho ; Hyung, Woo Jin ; Choi, Seung Ho ; Noh, Sung Hoon. / Safety and efficacy of fast-track surgery in laparoscopic distal gastrectomy for gastric cancer : A randomized clinical trial. In: World Journal of Surgery. 2012 ; Vol. 36, No. 12. pp. 2879-2887.
@article{22530eeadcc343a59b39bba8eb6e803e,
title = "Safety and efficacy of fast-track surgery in laparoscopic distal gastrectomy for gastric cancer: A randomized clinical trial",
abstract = "Background Fast-track surgery has been shown to enhance postoperative recovery in several surgical fields. This study aimed to evaluate the safety and efficacy of fasttrack surgery in laparoscopic distal gastrectomy. Methods The present study was designed as a singlecenter, randomized, unblinded, parallel-group trial. Patients were eligible if they had gastric cancer for which laparoscopic distal gastrectomy was indicated. The fasttrack surgery protocol included intensive preoperative education, a short duration of fasting, a preoperative carbohydrate load, early postoperative ambulation, early feeding, and sufficient pain control using local anesthetics perfused via a local anesthesia pump device, with limited use of opioids. The primary endpoint was the duration of possible and actual postoperative hospital stay. Results We randomized 47 patients into a fast-track group (n = 22) and a conventional pathway group (n = 22), with three patients withdrawn. The possible and actual postoperative hospital stays were shorter in the fasttrack group than in the conventional group (4.68 ± 0.65 vs. 7.05 ± 0.65; P <0.001 and 5.36 ± 1.46 vs. 7.95 ± 1.98; P <0.001). The time to first flatus and pain intensity were not different between groups; however, a greater frequency of additional pain control was needed in the conventional group (3.64 ± 3.66 vs. 1.64 ± 1.33; P = 0.023). The fast-track group was superior to the conventional group in several factors of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, including: fatigue, appetite loss, financial problems, and anxiety. The complication and readmission rates were similar between groups. Conclusions Fast-track surgery could enhance postoperative recovery, improve immediate postoperative quality of life, and be safely applied in laparoscopic distal gastrectomy.",
author = "Kim, {Jong Won} and Kim, {Whan Sik} and Cheong, {Jae Ho} and Hyung, {Woo Jin} and Choi, {Seung Ho} and Noh, {Sung Hoon}",
year = "2012",
month = "12",
doi = "10.1007/s00268-012-1741-7",
language = "English",
volume = "36",
pages = "2879--2887",
journal = "World Journal of Surgery",
issn = "0364-2313",
publisher = "Springer New York",
number = "12",

}

Safety and efficacy of fast-track surgery in laparoscopic distal gastrectomy for gastric cancer : A randomized clinical trial. / Kim, Jong Won; Kim, Whan Sik; Cheong, Jae Ho; Hyung, Woo Jin; Choi, Seung Ho; Noh, Sung Hoon.

In: World Journal of Surgery, Vol. 36, No. 12, 12.2012, p. 2879-2887.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Safety and efficacy of fast-track surgery in laparoscopic distal gastrectomy for gastric cancer

T2 - A randomized clinical trial

AU - Kim, Jong Won

AU - Kim, Whan Sik

AU - Cheong, Jae Ho

AU - Hyung, Woo Jin

AU - Choi, Seung Ho

AU - Noh, Sung Hoon

PY - 2012/12

Y1 - 2012/12

N2 - Background Fast-track surgery has been shown to enhance postoperative recovery in several surgical fields. This study aimed to evaluate the safety and efficacy of fasttrack surgery in laparoscopic distal gastrectomy. Methods The present study was designed as a singlecenter, randomized, unblinded, parallel-group trial. Patients were eligible if they had gastric cancer for which laparoscopic distal gastrectomy was indicated. The fasttrack surgery protocol included intensive preoperative education, a short duration of fasting, a preoperative carbohydrate load, early postoperative ambulation, early feeding, and sufficient pain control using local anesthetics perfused via a local anesthesia pump device, with limited use of opioids. The primary endpoint was the duration of possible and actual postoperative hospital stay. Results We randomized 47 patients into a fast-track group (n = 22) and a conventional pathway group (n = 22), with three patients withdrawn. The possible and actual postoperative hospital stays were shorter in the fasttrack group than in the conventional group (4.68 ± 0.65 vs. 7.05 ± 0.65; P <0.001 and 5.36 ± 1.46 vs. 7.95 ± 1.98; P <0.001). The time to first flatus and pain intensity were not different between groups; however, a greater frequency of additional pain control was needed in the conventional group (3.64 ± 3.66 vs. 1.64 ± 1.33; P = 0.023). The fast-track group was superior to the conventional group in several factors of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, including: fatigue, appetite loss, financial problems, and anxiety. The complication and readmission rates were similar between groups. Conclusions Fast-track surgery could enhance postoperative recovery, improve immediate postoperative quality of life, and be safely applied in laparoscopic distal gastrectomy.

AB - Background Fast-track surgery has been shown to enhance postoperative recovery in several surgical fields. This study aimed to evaluate the safety and efficacy of fasttrack surgery in laparoscopic distal gastrectomy. Methods The present study was designed as a singlecenter, randomized, unblinded, parallel-group trial. Patients were eligible if they had gastric cancer for which laparoscopic distal gastrectomy was indicated. The fasttrack surgery protocol included intensive preoperative education, a short duration of fasting, a preoperative carbohydrate load, early postoperative ambulation, early feeding, and sufficient pain control using local anesthetics perfused via a local anesthesia pump device, with limited use of opioids. The primary endpoint was the duration of possible and actual postoperative hospital stay. Results We randomized 47 patients into a fast-track group (n = 22) and a conventional pathway group (n = 22), with three patients withdrawn. The possible and actual postoperative hospital stays were shorter in the fasttrack group than in the conventional group (4.68 ± 0.65 vs. 7.05 ± 0.65; P <0.001 and 5.36 ± 1.46 vs. 7.95 ± 1.98; P <0.001). The time to first flatus and pain intensity were not different between groups; however, a greater frequency of additional pain control was needed in the conventional group (3.64 ± 3.66 vs. 1.64 ± 1.33; P = 0.023). The fast-track group was superior to the conventional group in several factors of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, including: fatigue, appetite loss, financial problems, and anxiety. The complication and readmission rates were similar between groups. Conclusions Fast-track surgery could enhance postoperative recovery, improve immediate postoperative quality of life, and be safely applied in laparoscopic distal gastrectomy.

UR - http://www.scopus.com/inward/record.url?scp=84877102426&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877102426&partnerID=8YFLogxK

U2 - 10.1007/s00268-012-1741-7

DO - 10.1007/s00268-012-1741-7

M3 - Article

C2 - 22941233

AN - SCOPUS:84877102426

VL - 36

SP - 2879

EP - 2887

JO - World Journal of Surgery

JF - World Journal of Surgery

SN - 0364-2313

IS - 12

ER -