Abstract：
BACKGROUND:Enhanced recovery after surgery (ERAS(®)) pathways have reduced morbidity and length of hospital stay (LOS) in orthopedics, bariatric, and colorectal surgery. New perioperative care protocols have been tested in patients undergoing pancreaticoduodenectomy (PD), with controversial results on morbidity. Incomplete data about ERAS items compliance have been reported. The aim of this study was to assess compliance with an ERAS protocol and its impact on short-term outcome in patients undergoing PD. METHODS:A comprehensive ERAS protocol was applied in 115 consecutive patients undergoing PD. Each ERAS patient was matched with one patient who received standard perioperative care. Match criteria were age, gender, malignant/benign disease, and PD-specific prognostic score. RESULTS:No adverse effect related to ERAS items occurred. Compliance with postoperative items ranged between 38 and 66 %. The ERAS group had an earlier recovery of mobilization (p < 0.001), oral feeding (p < 0.001), gut motility (p < 0.001), and an earlier suspension of intravenous fluids (p = 0.041). No difference between ERAS and control group was found in mortality, overall morbidity, and major complication rates. Subgroup analysis showed that 43/60 (71 %) patients with early postoperative low compliance with the ERAS pathway had complications. The ERAS pathway significantly shortened LOS in uneventful patients or those with minor complications (11.2 vs. 13.7 days, p = 0.001). CONCLUSION:The ERAS pathway was feasible and safe, yielding an earlier postoperative recovery. An ERAS protocol should be implemented in patients undergoing PD; however, patients with early postoperative low compliance should be carefully managed.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Braga M,Pecorelli N,Ariotti R,Capretti G,Greco M,Balzano G,Castoldi R,Beretta Ldoi
10.1007/s00268-014-2653-5subject
Has Abstractpub_date
2014-11-01 00:00:00pages
2960-6issue
11eissn
0364-2313issn
1432-2323journal_volume
38pub_type
杂志文章abstract：:In the original article Dennis Den Hartog's name was tagged incorrectly. It is correct as reflected here. ...
journal_title：World journal of surgery
pub_type： 杂志文章,已发布勘误
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pub_type： 杂志文章,meta分析,评审
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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