Resultados de la rehabilitación multimodal en la duodenopancreatectomía cefálica

Enhanced Recovery After Surgery Program in Patients Undergoing Pancreaticoduodenectomy

“…In 6 studies 11 , 24 , 29 , 30 , 35 , 36 only PD was performed, while PPPD was used as well as PD in 8 studies. 12 , 13 , 25 – 28 , 31 , 34 One Japanese study 28 included both PPPD and subtotal stomach-preserving PD alongside PD.…”

“…Kennedy et al 11 defined POPF as drainage of >30 mL with serum amylase level >3-fold for more than 10 days after surgery, while the diagnostic criteria were not described in the remaining 2 studies. 12 , 25 Eight studies 7 , 24 , 28 – 31 , 35 , 36 defined DGE as per ISGPS guidance, 3 studies 11 , 13 , 26 defined it as a need for nasogastric decompression, persistent vomiting or vomiting occurring after the 10th postoperative day, and the remaining 3 studies 12 , 25 , 34 did not state their criteria.…”

Integrating perioperative medicine with anaesthesia in India: Can the best be achieved? A review

“…Elements of the ERAS pathways for different surgical subgroups are essentially the same with minor modifications. [1516171819202122232425262728293031323334353637383940414243444546474849] General elements include preoperative nutritional screening, no preoperative bowel preparation, maltodextrin drink 2 h before surgery, prophylactic antibiotics, epidural or patient-controlled analgesia, prokinetic agents, goal-directed fluid therapy, early mobilisation, predefined criteria for removal of drains, nasogastric tubes and catheters, immediate extubation, early oral intake and a specific discharge plan. Surgery-specific elements like octreotide for pancreaticoduodenectomies, minimal tissue handling and minimally invasive surgery for urogynaecological oncosurgery or pharmacological thromboprophylaxis for head and neck free-flap surgery are important.…”

“…Advantages of adherence to ERAS are reduced length of hospital stay (LOS), reduced median operative time and intraoperative blood loss, reduced morbidity and complications, lower delayed gastric emptying rates, decreased insulin resistance, reduced IV fluid requirement during and for 3 days after surgery and improved 5-year survival [Table 1]. [1819202122232425262728293031323334353637383940414243444546474849] American Society for Enhanced Recovery and Perioperative Quality Initiative has recently (2018) issued joint consensus statements on optimal analgesia, prevention of postoperative infection, patient-reported outcome and postoperative gastrointestinal dysfunction within an ERAS pathway for colorectal surgery which were hitherto grey areas of the ERAS protocol, ushering an era of evidence-based perioperative medicine. [53545556575859] Return to intended oncotherapy is another recent parameter and time to adjuvant chemotherapy post colorectal cancer surgery is associated with an improved survival rate.…”