Implementation and achievements of enhanced recovery after surgery program in perioperative management of gastric cancer patients

Programs	n (%)
Postoperative complications
Gastroplegia	8 (2.4)
Pulmonary complication	1 (0.3)
Anastomotic leakage	1 (0.3)
Bleeding	1 (0.3)
Unplanned reoperation	1 (0.3)
Costs (in thousands, ¥)	59.5 ± 14.5
Hospital stay (d)	12 (5, 36)
Mortality	0

Variables	n (%)
Gender
Male	252 (76.6)
Female	77 (23.4)
Age (years)	63.8 ± 10.6
Height (cm)	166.2 ± 7.5
Body weight (kg)	63.6 ± 11.0
Education background
Senior high school or below	287 (87.2)
Junior college	19 (5.8)
Bachelor degree or above	23 (7.0)
Economic status
Below local level	55 (16.7)
In line with the local level	250 (76.0)
Above local level	24 (7.3)
Diseases history
Hypertension	127 (38.6)
Diabetes mellitus	34 (10.3)
Heart disease	22 (6.7)
Others	34 (10.3)
Number of complications
1	106 (32.2)
2	47 (14.3)
≥3	17 (5.2)
Number of previous surgeries
1	110 (33.4)
2	20 (6.1)
≥3	9 (2.7)
Family history
Yes	13 (4.0)
No	316 (96.0)
Radiotherapy
Yes	5 (1.5)
No	324 (98.5)
Chemotherapy
Yes	22 (6.7)
No	307 (93.3)
Smoking
Yes	133 (40.4)
No	196 (59.6)
Drinking
Yes	103 (31.3)
No	226 (68.7)

Programs	Value, n (%)
Postoperative oxygen therapy (h)	27.0 ± 18.4
Thromboprophylaxis
Compression stocking	8 (2.4)
Low-molecular-weight heparin	214 (65.0)
Combined	107 (32.5)
Antibiotics (days after operation)
1	116 (35.3)
2	73 (22.2)
≥3	140 (42.5)
Postoperative diet initiation (days after operation)
1–2	0 (0)
3	4 (1.2)
4	57 (17.3)
Upon gas passage	268 (81.5)
Intravenous fluid administration (days after operation)
1–3	0 (0)
4	9 (2.7)
≥5	320 (97.3)
Early mobilization on the bed (hours after operation)	9.5 ± 12.3
Early ambulation (hours after operation)	39.5 ± 12.5
Respiratory function training
Conventional method	292 (88.8)
Respiratory training device	37 (11.2)
Nutritional support after surgery	329 (100)
Passage of flatus (days after surgery)
1–2	7 (2.1)
3	59 (17.9)
≥4	263 (79.9)
Removal of nasogastric tube (days after surgery)
1	51 (15.5)
2	77 (23.4)
3	69 (21.0)
≥4	132 (40.1)
Removal of urinary catheter (days after surgery)
1	0 (0)
2	4 (1.2)
3	108 (32.8)
≥4	217 (66.0)

Programs	n (%)
Smoking cessation (weeks) (n = 133)
No	41 (30.8)
<8	46 (34.6)
≥8	46 (34.6)
Drinking cessation (weeks) (n = 103)
No	30 (29.1)
<4	35 (34.0)
≥4	38 (36.9)
Preoperative patient education and counseling	329 (100)
Avoidance of preoperative mechanical bowel preparation	80 (24.3)
Preoperative fasting (before surgery) (h)
≥24	11 (3.3)
12–24	202 (61.4)
6–12	116 (35.3)
Administration of carbohydrate-rich drink before surgery
Yes	2 (0.6)
No	327 (99.4)
Nutritional support before surgery
Yes	124 (37.7)
No	205 (62.3)
Caprini score before surgery
0–1 (extremely low-risk)	8 (2.4)
2 (low-risk)	31 (9.4)
3–4 (medium-risk)	204 (62.0)
≥5 (high-risk)	86 (26.1)
Thromboprophylaxis
No	196 (59.6)
Compression stocking	115 (35.0)
Low-molecular-weight heparin	18 (5.4)
Respiratory function training
Yes	37 (11.2)
No	292 (88.8)

Implementation and achievements of enhanced recovery after surgery program in perioperative management of gastric cancer patients†