Department of Visceral Surgery, Lausanne University Hospital CHUV and University of Lausanne UNIL, 1011, Lausanne, Switzerland.
Langenbecks Arch Surg. 2020 Aug;405(5):595-602. doi: 10.1007/s00423-020-01921-z. Epub 2020 Jul 1.
Enhanced recovery is a multimodal and evidence-based perioperative approach with the aim to improve postoperative outcome. Following successful results in colorectal surgery, the implementation of enhanced recovery has spread to many surgical disciplines including pancreatic surgery.
The aim of this study is to review current evidence on enhanced recovery focusing on pancreatic cancer surgery and to discuss potential areas of further development.
In pancreatic cancer surgery, enhanced recovery is associated with better clinical outcome, especially reduced overall postoperative complications, and reduced length of stay without any increase in readmission rate. The occurrence of delayed gastric emptying, but not pancreatic fistula, seems to be reduced with enhanced recovery. The improved postoperative outcome correlates with net costs savings. The improvement of clinical outcome was mainly described for short-term complications. The extension to long-term outcome and survival benefits, as well as the impact on quality of life, remains to be determined.
强化康复是一种多模式的、基于证据的围手术期方法，旨在改善术后结果。在结直肠手术后取得成功后，强化康复已扩展到许多外科领域，包括胰腺外科。
本研究旨在回顾强化康复在胰腺癌手术中的现有证据，并讨论进一步发展的潜在领域。
在胰腺癌手术中，强化康复与更好的临床结果相关，尤其是减少了整体术后并发症，并且住院时间缩短而没有增加再入院率。强化康复似乎可减少延迟性胃排空的发生，但不会减少胰瘘的发生。术后结果的改善与净成本节约相关。临床结果的改善主要描述了短期并发症。扩展到长期结果和生存获益，以及对生活质量的影响，仍有待确定。
