Gastroenterology · 2 h ago
ERAS was non-inferior to conventional care after upper GI endoscopic resection
In a single-center randomized non-inferiority trial of 165 patients with upper gastrointestinal lesions ≤2 cm, enhanced recovery after surgery (ERAS) met the prespecified non-inferiority criterion for postoperative complications. Patients assigned to ERAS also had earlier recovery milestones, shorter hospital stays and lower hospitalization costs.
- Complication outcomes met the prespecified non-inferiority criterion.
- ERAS patients reached recovery milestones earlier.
- Hospital stays and costs were lower with ERAS.
- Trial was single-center and limited to lesions ≤2 cm.
The trial randomized 165 patients undergoing endoscopic resection of upper gastrointestinal lesions ≤2 cm to ERAS-based perioperative care (55 patients) or conventional recovery after surgery (CRAS; 110 patients). Procedures included STER, ESD, ESE or EFTR. The primary endpoint was postoperative complications, assessed against a non-inferiority margin of 5%; secondary outcomes included pain, recovery measures, length of stay and costs.
The complication risk difference for ERAS versus CRAS was −0.91% (90% CI, −3.97% to 3.83%), meeting the prespecified non-inferiority criterion. Median pain scores were lower with ERAS (VAS 0 vs 2; p=0.020). ERAS patients also had shorter nasogastric tube duration and earlier oral water, feeding and ambulation (all p<0.001). Postoperative and total hospital stays, as well as hospitalization costs, were also lower (all p<0.001).
These findings support further evaluation of ERAS pathways for selected patients undergoing upper GI endoscopic resection. Applicability is limited by the single-center design and the selected population with lesions ≤2 cm; the results do not establish outcomes in other settings or patient groups.
In practice
For patients with upper gastrointestinal lesions ≤2 cm undergoing endoscopic resection, this single-center randomized trial found ERAS-based perioperative care non-inferior to conventional care for postoperative complications and associated with earlier recovery milestones and shorter, less costly hospital stays. The findings are promising for perioperative pathway planning, but the study’s single-center setting and selected population limit generalizability. It does not establish that the same results apply to larger lesions, other centers or different patient groups.
AI-generated clinical interpretation · Not editor-reviewed
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Surgical Endoscopy: Enhanced recovery after surgery (ERAS) for endoscopic resection of upper gastrointestinal lesions ≤ 2 cm: a single-center, 1:2 randomized, controlled, non-inferiority trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.