Role of protocol-guided perioperative care to enhance recovery after head and neck neoplasm surgery: An institutional experience

Abstract

Background: Enhanced recovery after surgery (ERAS) improve recovery after surgery. This study aimed to determine whether ERAS leads to a decrease in stay in the hospital and improves global and functional recovery after head and neck neoplasms surgery.

Methods: We performed a prospective case and historical control study after the ERAS application. The hospital database selected 50 confirmed eligible patients in control non-ERAS group. Prospectively 54 patients were included in the ERAS group. The primary outcome was time to readiness for discharge (TRD); secondary outcomes were the length of stay (LOS), readmission rate of up to 30 days and Quality of recovery score QoR-15. Data were compared with appropriate parametric and nonparametric tests.

Results: Baseline demographic data of patients were comparable between the two groups. Patients in ERAS group had significantly shorter TRD compared to the non-ERAS group 8 (6-10) vs 11 (8-16); p-value = 0.002. LOS was also significantly shorter in the ERAS group compared to the non-ERAS group [8 (7-11) vs 12 (9-17); p-value = 0.002]. Readmission at 30-days was no different, with six patients in each group. QoR-15 score was statistically better in ERAS group (94.88 ± 12.50) compared to non-ERAS group (85.44 ± 12.68) [p value < 0.001].

Conclusion: Implementing the ERAS programme decreased TRD and LOS and improved patient-reported recovery outcome QoR-15 in head and neck neoplasms surgery.

Keywords: Cirugía de cáncer de cabeza y cuello; Duración de la estancia; Enhanced recovery after surgery; Head and neck cancer surgery; Length of stay; Mejora de la recuperación tras la cirugía; Perioperative care; Puntuación de calidad de la recuperación QoR-15; Quality of recovery 15 score; Tiempo hasta la disposición para el alta; Time to readiness for discharge.