by N. Gort, B.G.I. van Gaal, H.J.P. Tielemans, D.J.O.
Ulrich, S. Hummelink
The Breast: August 19, 2021
Background
Enhanced recovery after surgery protocols are successfully
implemented in different surgical specialties, but a specific protocol for
autologous breast reconstruction is missing. The aim of this study was to
determine whether an enhanced recovery after surgery (ERAS) protocol
contributes to a reduced length of stay without an increase in postoperative
complications for patients undergoing a DIEP flap breast reconstruction.
Materials en methods
The effect of the ERAS protocol was examined using a
single-center patient-control study comparing two groups of patients. Patients
who underwent surgery between November 2017 and November 2018 using the ERAS
protocol were compared with a historical control group (pre-ERAS) who underwent
surgery between November 2016 and November 2017. The primary outcome measure
was hospital length of stay. Secondary outcome measures were postoperative pain
and postoperative complications.
Results
152 patients were included (ERAS group, n = 73;
control group, n = 79). Mean hospital length of stay was
significantly shorter in the ERAS group than in the control group (5 vs. 6
days, p < 0.001). The average pain score was 1.73 in de the ERAS
group compared to 2.17 in the control group (p = 0.032). There were
no significant differences between the groups in postoperative complications.
The ERAS group experienced less constipation (41 vs. 25 patients,
p = 0.028).
Conclusion
An enhanced recovery after surgery protocol contributes an
accelerated postoperative recovery of patients undergoing a DIEP flap breast
reconstruction. In this study a significant decrease was found in hospital
length of stay, patient-reported pain score and adverse health issues.
