TITLE:
A Modified Enhanced Recovery after Surgery (ERAS): Use and Surgical Outcome in Breast Cancer Patients
AUTHORS:
Tajudeen A. Wahab, Hanna Uwakwe, Maher Jumah, Rilwan Aransi, Humayun Kabir Khan
KEYWORDS:
ERAS®, Breast Cancer, Surgical Outcome
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.6 No.3,
March
14,
2018
ABSTRACT: Background: ERAS protocols are perioperative interventions
aimed at reducing postoperative complications, length of hospital stay (LOS)
and early return to normal activities. This has improved outcome in many
surgical specialties, including breast surgery. We present the surgical outcome
of breast cancer (BC) patients treated over a 12-month period following the principle of ERAS protocols
and highlight the underpinning evidence. Methods: A retrospective
analysis of all BC patients diagnosed and had breast cancer surgery over 12
months. Data collected included patient’s demographics, type of surgery, LOS,
other perioperative care and significant postoperative complications. Excluded
were patients with bilateral cancer surgeries, diagnostic excision, margin
clearance or breast reconstruction. Results: There were 621 BC
diagnosed including 5 male and 12 bilateral female BC. The ages ranged from 25
to 93 years. Excluding bilateral BC, 351 patients (70.2 %) had
breast conserving surgery (BCS) while 149 (29.8%) patients had mastectomy as index cancer surgery.
Sixteen (4.5%) of the women who initially underwent BCS subsequently had a
completion mastectomy. The overall rate of successful BCS was 335/500 (67%).
441 (85.5%) of patients were discharged same or next day. 12 (7.2%) cases of
postoperative haematoma, 6 cases of wound infection and a case of seroma requiring
surgical/radiological drainage recorded. Conclusion: ERAS
protocol in BC surgery is associated with decreased LOS and low complication
rate. Delayed discharges are mostly due to adverse social factors and medical
comorbidity rather than post-operative surgical complications.