Bai Xueli, Zhang Xiaoyu, Lu Fangyan, Li Guogang, Gao Shunliang, Lou Jianying, Zhang Yun, Ma Tao, Wang Ji, Chen Wei, Huang Bingfeng, Liang Tingbo
Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; Collaborative Innovation Center for Cancer Medicine, Zhejiang University, Hangzhou, China.
Pancreatology. 2016 Jul-Aug;16(4):665-70. doi: 10.1016/j.pan.2016.03.018. Epub 2016 Apr 5.
The experience of implementing enhanced recovery after surgery (ERAS) programs in pancreatic surgery is limited. The aim of this study was to evaluate the feasibility of ERAS program in pancreatic surgery in an academic medical center of China.
Between May 2014 and August 2015, 124 patients managed with an ERAS program following pancreatic surgery (ERAS group), were compared to a historical cohort of 63 patients, treated with traditional perioperative care between August 2013 and April 2014 (no-ERAS group). Postoperative hospital stay (POPH), unplanned reoperation, unplanned readmissions, mortality and complications were compared between the two groups.
Mean POPH of all patients was significantly reduced (p = 0.007) from 17.1 days (no-ERAS group) to 11.7 days (ERAS group). Especially, mean POPH was reduced significantly in ERAS group of patient with no (7.0 vs. 8.7, p = 0.020) or grade I-II (10.6 vs. 14.4, p = 0.001) complications. There was no difference of complication grades and types between two groups, as well as the rate of mortality, unplanned reoperation and readmission.
The ERAS program is safe and feasible for patients undergoing pancreatic surgery, and it can decrease the postoperative hospital stay.
在胰腺手术中实施加速康复外科（ERAS）计划的经验有限。本研究的目的是评估在中国一家学术医疗中心的胰腺手术中实施ERAS计划的可行性。
2014年5月至2015年8月期间，124例接受胰腺手术后采用ERAS计划管理的患者（ERAS组），与2013年8月至2014年4月期间接受传统围手术期护理的63例患者的历史队列（非ERAS组）进行比较。比较两组患者的术后住院时间（POPH）、非计划再次手术、非计划再入院、死亡率和并发症情况。
所有患者的平均POPH显著缩短（p = 0.007），从17.1天（非ERAS组）降至11.7天（ERAS组）。特别是，无并发症（7.0天对8.7天，p = 0.020）或I-II级并发症（10.6天对14.4天，p = 0.001）的ERAS组患者的平均POPH显著缩短。两组之间的并发症等级和类型、死亡率、非计划再次手术率和再入院率均无差异。
ERAS计划对于接受胰腺手术的患者是安全可行的，并且可以缩短术后住院时间。
