Reducing postoperative complications and improving clinical outcome: Enhanced recovery after surgery in pancreaticoduodenectomy – A retrospective cohort study
| Autor: | Deliang Fu, Yongjian Jiang, Juntao Dai |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Gastroparesis Adolescent Referral medicine.medical_treatment 030230 surgery Patient Readmission Perioperative Care Pancreaticoduodenectomy Tertiary Care Centers Fight-or-flight response Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Humans Medicine Enhanced recovery after surgery Aged Retrospective Studies Aged 80 and over Gastric emptying business.industry Mortality rate Anastomosis Surgical Retrospective cohort study Recovery of Function General Medicine Length of Stay Middle Aged medicine.disease Surgery Intestines Treatment Outcome Pancreatic fistula 030220 oncology & carcinogenesis Feasibility Studies Female business Program Evaluation |
| Zdroj: | International Journal of Surgery. 39:176-181 |
| ISSN: | 1743-9191 |
| DOI: | 10.1016/j.ijsu.2017.01.089 |
| Popis: | Background An enhanced recovery after surgery (ERAS) programme aims to reduce the stress response to surgery and thereby accelerate recovery. The experience of implementing the ERAS programmes in pancreatoduodenectomy (PD) is relatively limited. The aim of this study was to evaluate the feasibility, safety and clinical outcomes of the ERAS programme after PD at a high-volume Chinese university referral centre. Methods Between September 2014 and July 2016, a retrospective analysis of 166 consecutive patients who underwent PD at a tertiary referral care center was carried out. Ninety-eight patients who received conventional perioperative management (the conventional group) were compared with 68 patients who received ERAS programme (the ERAS group). The incidences of postoperative complications, length of stay, expenses, postoperative readmissions, and reoperation rates were compared. Results A total of 166 patients who underwent PD were analysed (68 patients in the ERAS group, and 98 patients in the conventional group). There were no significant differences in mortality, reoperation, and readmission rates. The ERAS group had a lower morbidity rate than the conventional group (50% vs. 90.8%; P = 0.00), as well as a shorter length of hospital stay (7.5 vs 12 days; P = 0.00). Delayed gastric emptying was significantly reduced in the ERAS group (0 vs. 11.2%; P = 0.011). Pancreatic fistula (grade B,C) was significantly reduced in the ERAS group (14.7 vs 30.6%; P = 0.018). The median total hospital cost was also significantly reduced in the ERAS group (¥79790.40 vs ¥102982.81; P = 0.000). Conclusion The ERAS programme is feasible and safe in patients who underwent PD, and it can reduce postoperative complications and improve clinical outcomes. |
| Databáze: | OpenAIRE |
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