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Master Thesis

Impact d’un protocole de réhabilitation précoce dans la chirurgie de l’oesophage

Abstract : Background: enhanced recovery (ER) protocols enable patients to recover faster, and decrease postoperative complications (POC). The impact of such protocols has rarely been studied in oesophagus surgery, a field that entails a great number of POC and a high in-hospital mortality rate. Methods: we carried out a retrospective study “before/after” the implementation of a multidisciplinary ER protocol. All the patients who had undergone oesophagectomy between January 2009 and September 2016, for oesophagus cancer, have been included. The ER protocol included the patient’s respiratory preparation, the systematic treatment of pain with thoracic epidural analgesia, minimally invasive surgery and early mobilization. The length of the stay, the in-hospital mortality, POC and the oncological follow-up care were compared between the two groups. Results: we included 227 patients, 73 of whom received standard care and 154 of whom benefited from the implementation of an ER protocol (ER group). The two groups of patients were similar in terms of demographic characteristics. The length of hospital stay was shorter in the ER group: 12.5 days (11-16) versus 15 days (13-22) (P=0.0002). There was no difference in the mortality rate (6 % in the ER group versus 8 % in the control group) nor in POC. Patients from the ER group showed a higher complete cancer remission rate (P=0.02). Conclusion: implementing an ER protocol within the scope of oesophagus surgery causes a decrease in the length of hospital stay and might reduce the risk of cancer recurrence.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01517898
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Wednesday, May 3, 2017 - 6:34:12 PM
Last modification on : Friday, September 8, 2017 - 1:09:19 AM

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Simon Monziols. Impact d’un protocole de réhabilitation précoce dans la chirurgie de l’oesophage. Médecine humaine et pathologie. 2017. ⟨dumas-01517898⟩

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