447. IMPACT OF PERIOPERATIVE MANAGEMENT BASED ON ERAS IN THORACIC ESOPHAGEAL CANCER SURGERY. (24th September 2022) - Muroya, Takahiro
Abstract: Esophagectomy for esophageal cancer is one of the most invasive surgeries, thus it has high morbidity and mortality rates. A multidisciplinary perioperative management is required for improvement in surgical outcomes. Early recovery after surgery (ERAS) is now standard in the care of patients and has been associated with reduced complication rates and hospital stays. The aim of this study was to evaluate the impact of perioperative management based on ERAS for thoracic esophageal cancer patients. A total 357 patients performed esophagectomy between January 2009 and August 2020 were enrolled. Patients were classified into non-ERAS (NE) group (n = 174) and ERAS (E) group (n = 183). Operative outcomes were compared between two groups. Postoperative complications were graded according to Clavien-Dindo classification. The complication defined as above Grade 3. Nutritional Status was evaluated with Controlling nutritional status (CONUT). Changes in body weight (BW) and area of psoas muscle mass at 3 months after surgery were evaluated. Operative factors such as operative time and blood loss were not significant different between the NE and E groups. In E group, Postoperative any complications (p = 0.023), respiratory complications (p = 0.043) were significantly less than in NE group. CONUT score was lower on postoperative 1 month (p = 0.025) and 3 months (p = 0.044) in E group. Reduction rate of BW and psoas muscle mass index (PMI) on postoperative 3 months in E group was lower than in NE group (BW: 5.6 ± 6.4% vs 7.8 ± 5.2% (p = 0.045), PMI: 6.7 ± 14.9% vs 12.3 ± 13.3% (p = 0.021)). ERAS could be effective for maintenance of a better nutritional status and prevention of the postoperative respiratory complication and loss of the BW and PMI.