Perioperative care in primary retroperitoneal sarcoma surgery: A Hispano-Luso survey on current practices.

Autores de IIS La Fe

• Cristina Ballester Ibáñez

  Autor

Participantes ajenos a IIS La Fe

• Lozano Lominchar P
• Muñoz P
• Muñoz Casares C
• Díaz D
• Olivares-Ripoll V
• Marrero P
• Cambeiro L
• López I
• Vasques H
• Asencio JM
• Spanish Society of Surgeons, the Portuguese Sarcoma Group (Society of Surgeons)

Grupos

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Abstract

BACKGROUND: Retroperitoneal sarcoma (RPS) is a rare malignancy requiring complex surgical management. While Enhanced Recovery After Surgery (ERAS) protocols have improved outcomes in various surgical specialties, their implementation in RPS remains inconsistent. OBJECTIVE: This study aimed to evaluate current perioperative care practices for RPS surgery across Spain and Portugal, identifying gaps in protocol standardization and assessing the feasibility of consensus-based approaches. METHODS: A structured online survey was distributed to members of the Spanish and Portuguese Societies of Surgeons. The questionnaire encompassed five domains: demographics, preoperative, intraoperative, and postoperative practices, and attitudes toward perioperative consensus. RESULTS: Among 266 survey accesses, 37 complete responses were analyzed. Only 27% of respondents reported having a dedicated ERAS protocol for RPS, though 89.2% employed ERAS pathways for other surgeries. Prehabilitation elements - such as smoking cessation (21.6%), nutritional support (73%), and supervised physical therapy (37.8%) - were inconsistently applied. Intraoperatively, goal-directed fluid therapy was used by 51.4%, while 97.3% adhered to restrictive transfusion thresholds. Postoperative variability was notable in diet resumption, mobilization, and nasogastric tube use. All respondents supported the creation of an RPS-specific perioperative care consensus. CONCLUSIONS: There is marked heterogeneity in perioperative care for RPS across Iberian centers. Standardized, evidence-based guidelines are urgently needed to improve consistency and optimize patient outcomes.

Copyright © 2025 AEC. Published by Elsevier España, S.L.U. All rights reserved.

Keywords

• Cuidados perioperatorios; ERAS; Estudio de encuesta; Oncología quirúrgica; Perioperative care; Prehabilitación; Prehabilitation; Retroperitoneal sarcoma; Sarcoma retroperitoneal; Surgical oncology; Survey study