Skip to main content

Table 1 Clinical pathway details

From: The application of enhanced recovery after surgery in total gastrectomy: a propensity score-matched analysis

 

Conventional group

Modified group

Perioperative

Counseling

Pulmonary rehabilitation

Pathway explanation and informative booklet

Intraoperative

Analgesia

Not standardized

Multimodal: TAP block for laparoscopic surgery + CNS-targeted drugs

Prophylaxis

Antibiotic prophylaxis, VTE (pharmacological and mechanical)

Antibiotic prophylaxis, VTE (pharmacological and mechanical)

Fluids

Not standardized

Goal-directed fluid management

Extubation

Immediate extubation

Immediate extubation

NGT

Remove on POD 1

Remove at the end of surgery

Postoperative

Analgesia

Not standardized

NSAIDs

Fluid

Not standardized

Zero balance goal; stop iv fluid within POD 4

Abdominal drain

Always placed

Always placed. No routine anastomotic leak test. Removed on POD 5

Line management

Not standardized

Remove urinary catheter on POD 2

Diet

POD 2 clear fluids, POD 4 soft diet

POD 1 clear fluids, POD 2,3 nutritional supplement, POD 4 soft diet

Rehabilitation

Not standardized

POD 1–3 pulmonary physiotherapy

POD 1 chair and bedside exercise

POD 2–3 assisted ambulation

Herbal medicine

None

Dai-kenchu-to (15 g/day)

  1. TAP transversus abdominis plane, CNS central nervous system, VTE venous thromboembolism, NGT nasogastric tube, POD postoperative day