Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC), has improved survival and quality of life for patients with peritoneal surface malignancies. ERAS has been proven to be safe while still maintaining acceptable outcomes for these patients. In the Philippine setting, no data has reported on the outcomes and compliance rates of an ERAS protocol for patients undergoing CRS with HIPEC.
Objective: To determine compliance rates of patients and the ERAS Multidisciplinary (MDT) members in the implementation of ERAS for CRS with HIPEC.
Research Design: Cross-sectional study design.
Methods: Data of patients who underwent CRS with HIPEC were obtained from the patient information systems of the PGH. The 12-page ERAS Clinical Pathway Checklist was used. The checklist was digitally recorded in the ERAS® Interactive Audit System (EIAS), a web-based data entry and analysis system for analysis and interpretation.
Patient criteria: All patients aged 18 years old and above enrolled in ERAS who underwent CRS with HIPEC from January 1, 2019 to December 31, 2022.
Intervention: Application of the ERAS protocol components for patients undergoing CRS with HIPEC.
Outcomes: Primary outcome is compliance rates. Secondary outcomes are length of stay, length of ICU stay, post-operative course, readmission rates, and 30-day mortality and morbidity rates
Results: A total of 27 CRS HIPEC patients were enrolled under the ERAS protocol from 2019 to 2022. The team’s compliance rate perioperatively for patients who underwent CRS HIPEC enrolled in ERAS was 43.9%. The median LOS was 8 days with a median ICU stay of 1 day and postoperative length of stay at a median of 6 days. Readmission rate was 11.1%. Morbidity rate was 37% and mortality rate at 3.7%.
Conclusion: ERAS is a promising adjunct in CRS with HIPEC as it has acceptable outcomes and did not increase the hospital LOS, ICU stay and complication rate.