Trial Information

Phase II Study Evaluating the Compliance to the Enhanced Recovery After Surgery (ERAS) Program in Patients Undergoing Gastrectomy for Gastric Carcinoma

The feasibility and effectiveness of ERAS program for various major surgical procedures have
been well studies in the literature. However, ERAS program has not been widely accepted for
patients undergoing gastric cancer surgery because of the paucity of evidence about its
feasibility and efficacy. In this study, we developed ERAS program for gastric cancer
surgery, based on the systemic review about perioperative cares. The main elements of ERAS
program includes: 1preoperative patient education, 2)no preoperative bowel preparation, 3)
provision of normal diet until the night before surgery, 4)carbohydrate rich drink 2 hrs
before surgery, 5)epidural anesthesia for pain control, 6) local wound anesthetic
infiltration for pain control, 7)no routine abdominal drain, 8)no naso-gastric tube
insertion, 9)intraoperative antibiotics, 10)thromboprophylaxis using intermittent pneumatic
compression device, 11)intraoperative normothermia using warm air blanket, 12)low oxygen
supply during immediate postoperative period, 13)restrictive postoperative fluid
administration, 14)early postoperative oral diet, 15)early active ambulation, 16)early
removal of the urinary catheter, 17)patient education before discharge, and 18)hospital
discharge based on discharge criteria.

The aim of study is to evaluate the compliance to these main elements of ERAS program in
patients undergoing gastric cancer surgery.

Previously reported data about ERAS program for colon surgery reported overall compliance as
about 65%. Considering that this is a single center study, we expected overall compliance
rate of 70%. Therefore, the sample size of 173 patients was calculated based on this
expected compliance rate, with permitted error of 95% confidence interval of 14%.