Systematic Review and Meta‐analysis of Enhanced Recovery After Pancreatic Surgery with Particular Emphasis on Pancreaticoduodenectomies

Coolsen, Mariëlle M.E.; Dam, Ronald M. van; Wilt, A. A. van der; Slim, K.; Lassen, Kristoffer; Dejong, Cornelis H. C.

doi:10.1007/s00268-013-2044-3

Cited by 193 publications

(171 citation statements)

References 71 publications

(95 reference statements)

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“…The common outcome derived from the results of many literature studies is that in addition to all contributions of ERAS protocol, it does not change the postoperative mortality rates and duration of rehospitalization [26][27][28][29][30][31]. However, since it requires a robust team work its implementation in every institute or unit is not easy [32].…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

2018

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Objectives: In the present study, we aimed to compare the postoperative compliance and complications between ERAS and conventional postoperative care in patients undergoing abdominal hysterectomies. Material and methods:This is the prospective, randomized, controlled trial, which involved 62 patients, who underwent abdominal hysterectomy between December 2016 to February 2017. A total of 30 patients formed the ERAS group. A total of 32 patients who received conventional perioperative care and matched for age, body mass index (BMI) and American Society of Anesthesiologists score were assigned as a control group. Groups were compared in terms of patient characteristics [age, body mass index, ASA Score, parity, diagnosis, type of surgery, and perioperative intravenous fluids], postoperative compliance (postoperative intravenous fluids, time to first flatus, first defecation, ambulation, eating solid food, and postoperative hospital stay), and postoperative complications.Results: Peri-and post-operative administrated intravenous fluids were significantly lower in the ERAS group (p < 0.001 for both). Time to first flatus (p = 0.001), time to first defecation (p < 0.001), and time to eating solid food (p < 0.001) were all significantly shorter in the ERAS group. Post-operative early mobilization on the first postoperative day was achieved in eight (26.7%) patients in the ERAS group. There were no significant differences in complications. One (3.3%) patient in the ERAS Group and 11 (34.4%) patients in the Conventional Group required hospital readmission after discharge (p = 0.002). Conclusion:The ERAS protocol seems to be a simple tool for reducing the incidence of postoperative complications and shortening hospitalization.

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Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

2018

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“…Several other fields of surgery have since adopted the ERAS program, achieving better postoperative outcome and decreasing length of postoperative hospitalization [6,7,8,9,10,11,12]. In pancreatic surgery, a recent systematic review and meta-analysis suggested that an ERAS program reduces hospital stay and morbidity for PD [13]. Also, in another study of 145 patients undergoing pancreatic surgery, implementing an ERAS program appeared to be feasible and safe [14].…”

Section: Introductionmentioning

confidence: 99%

Improving Outcome after Pancreaticoduodenectomy: Experiences with Implementing an Enhanced Recovery After Surgery (ERAS) Program

et al. 2014

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Background: Pancreaticoduodenectomies (PDs) are complex surgical procedures that require high-standard perioperative care. The objective of this study was to evaluate the effects of implementing an Enhanced Recovery After Surgery (ERAS) program for PD on patient outcome. Methods: 230 patients undergoing PD in the Maastricht University Medical Centre between January 1995 and January 2012 were included. Group 1 (no ERAS; 1995-2005) received traditional care. From January 2006, several elements of an ERAS pathway for pancreatic surgery were implemented (group 2: ‘ERAS-like'). From 2009 onwards the ERAS pathway was fully implemented (group 3: ERAS). Mortality, complications, readmissions and length of hospital stay (LOS) were evaluated in the subgroups and compared. Results: Median LOS was significantly reduced from 20 days in group 1 to 13 days in group 2 and 14 days in group 3 (p = 0.001). Median LOS of patients without complications was 16, 10 and 9 days in groups 1, 2 and 3, respectively (p < 0.0001). Over time, the average age of patients undergoing PD increased significantly. Complication rates as well as mortality and readmission rates did not change over time. Conclusion: Implementing an ERAS program contributed to a decrease of LOS without compromising other outcomes. Mortality, morbidity and readmission rates stayed unchanged and more complications were managed non-operatively.

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“…Postoperative enhanced recovery protocols (ERPs) focus on improving surgical outcomes through standardized postoperative fast-track protocols, and were first described in colorectal surgery, urology, and gynecology (9)(10)(11)(12)(13). Surgical goals in patients with lung cancer should include a short trajectory time between diagnosis and surgery, a short hospital stay, and expedited return to daily activities.…”

Section: Original Articlementioning

confidence: 99%

Enhanced recovery pathways in thoracic surgery: the Quebec experience

Hubert¹,

Bourdages-Pageau²,

Garneau³

et al. 2018

J. Thorac. Dis.

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Background: Canada has a universal public health system where all resources must be allocated to optimize cost-effectiveness. Rapid diagnostic assessment programs (DAPs) and enhanced recovery protocols Conclusions: DAPs and ERPs have promising roles in thoracic surgical practice. A rapid DAP can expedite the care trajectory of patients with lung cancer and has allowed our institution to adhere to governmental standards for the management of lung cancer. ERPs are feasible to establish and can effectively improve clinical outcomes.

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Systematic Review and Meta‐analysis of Enhanced Recovery After Pancreatic Surgery with Particular Emphasis on Pancreaticoduodenectomies

Cited by 193 publications

References 71 publications

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

Improving Outcome after Pancreaticoduodenectomy: Experiences with Implementing an Enhanced Recovery After Surgery (ERAS) Program

Enhanced recovery pathways in thoracic surgery: the Quebec experience

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