Document Detail

Effectiveness of a written clinical pathway for enhanced recovery after transthoracic (Ivor Lewis) oesophagectomy.
MedLine Citation:
PMID:  20187171     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study assessed the feasibility of a protocol-driven written clinical pathway for multidisciplinary postoperative management after oesophagectomy for oesophageal neoplasia, and examined whether the application of such a protocol could shorten hospital stay and reduce postoperative morbidity and mortality. METHODS: Consecutive patients undergoing transthoracic oesophagectomy for oesophageal neoplasia were divided into those treated between 2003 and 2008 to whom a clinical pathway was applied for postoperative management (group 1), and a control group treated between 1998 and 2002 when no clinical pathway was applied (group 2). RESULTS: There were 74 patients in each group. Morbidity rates were similar in the two groups: 31 per cent in group 1 and 38 per cent in group 2. There were more pulmonary complications in group 2 (23 versus 14 per cent; P = 0.025). One patient (1 per cent) in group 1 and four (5 per cent) in group 2 died after surgery (P = 0.010). The median (range) length of hospital stay was 9 (5-98) days for group 1 and 13 (8-106) days in group 2 (P = 0.012). CONCLUSION: Use of a written clinical pathway in patients undergoing oesophageal resection significantly reduced pulmonary complications, postoperative mortality and hospital stay.
V Munitiz; L F Martinez-de-Haro; A Ortiz; D Ruiz-de-Angulo; P Pastor; P Parrilla
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  97     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-15     Completed Date:  2010-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  714-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 British Journal of Surgery Society Ltd.
Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Murcia, Spain.
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MeSH Terms
Critical Pathways / standards*
Esophageal Neoplasms / surgery*
Esophagectomy / methods*
Feasibility Studies
Length of Stay
Middle Aged
Postoperative Care / methods
Treatment Outcome
Young Adult

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