Improved Outcomes in 394 Pancreatic Cancer Resections: the Impact of Enhanced Recovery Pathway

Agarwal, Vandana; Thomas, Martin; Joshi, Riddhi; Chaudhari, Vikram; Bhandare, Manish; Mitra, Abhishek; Desouza, Ashwin; Ambulkar, Reshma; Shrikhande, Shailesh V.

doi:10.1007/s11605-018-3809-7

Cited by 39 publications

(28 citation statements)

References 32 publications

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“…Compliance with enhanced recovery after surgery (ERAS) elements has been favorably associated with reduced morbidity and length of stay and cost with no impact on readmission across surgical specialties. [108109110] Despite these positive results, evidence regarding ERAS in patients undergoing CRS-HIPEC procedures is lacking. The feasibility and benefits of ERAS in patients undergoing CRS-HIPEC were evaluated retrospectively before and after ERAS protocol and it was observed that the ERAS pathway was associated with significant reduction in the length of stay and early gastrointestinal recovery with no difference in morbidity and mortality.…”

Section: Enhanced Recovery After Surgery and Crs-hipecmentioning

confidence: 99%

Society of Onco-Anaesthesia and Perioperative Care consensus guidelines for perioperative management of patients for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

et al. 2019

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Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) for primary peritoneal malignancies or peritoneal spread of malignant neoplasm is being done at many centres worldwide. Perioperative management is challenging with varied haemodynamic and temperature instabilities, and the literature is scarce in many aspects of its perioperative management. There is a need to have coalition of the existing evidence and experts' consensus opinion for better perioperative management. The purpose of this consensus practice guideline is to provide consensus for best practice pattern based on the best available evidence by the expert committee of the Society of Onco-Anaesthesia and Perioperative Care comprising perioperative physicians for better perioperative management of patients of CRS-HIPEC.

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Section: Enhanced Recovery After Surgery and Crs-hipecmentioning

confidence: 99%

Society of Onco-Anaesthesia and Perioperative Care consensus guidelines for perioperative management of patients for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

et al. 2019

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“…In consideration of the relevant risk of postoperative complications and the poor survival, it has generally been accepted that for PDAC patients with metastatic disease, resection of the primary tumor or metastatic lesions is contraindicated. However, with the rapid development of new surgical techniques, more precise and minimally invasive operations, and better perioperative care, morbidity and mortality of pancreatic surgery has decreased in experienced centers 3,6 . New chemotherapeutic regimens also significantly prolong the survival of PDAC patients with metastatic tumors 7,8 .…”

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confidence: 99%

Surgery for synchronous and metachronous single-organ metastasis of pancreatic cancer: a SEER database analysis and systematic literature review

Liu

Michalski

Liu

et al. 2020

Sci Rep

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Surgery for metastatic pancreatic cancer remains controversial as the survival benefit is questionable. the aim of the present study was to analyze the survival of these patients using data extracted from the surveillance, epidemiology, and end results (SeeR) program database. further, studies on resection for metastatic disease to the lung were systematically reviewed. A total of 11,541 cases with synchronous distant metastasis were analyzed. the median survival of single-organ metastasis was better than of multi-organ metastasis (single-organ 4.0 ± 0.07 months, two-organs 3.0 ± 0.13 months, three/fourorgans 2.0 ± 0.19 months; p < 0.0001). Single organ lung metastasis had longer median survival times compared to the other sites (lung 6.0 ± 0.32 months, HR 0.87, 95% CI 0.78-0.97; p = 0.013). Resection of the primary tumor was associated with longer survival in synchronous single-organ metastasis to the lung compared to no resection (14.0 ± 1.93 months vs 6.0 ± 0.31 months, p < 0.0001). A systematic literature review identified 79 cases of metachronous lung metastasis with a survival of 120.0 ± 6.32 months and 83.0 ± 24.84 months following resection of the primary tumor and metastasis, respectively. Lower tnM staging, longer interval to metastasis, and single metastatic lesion correlated with better survival. Resection in highly selected pancreatic cancer patients with synchronous and metachronous lung only metastasis might confer a survival benefit and should be considered on an individual basis.

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“…In similar side, the study of Enhanced recovery after surgery in gastrointestinal surgery done by Gao, et al [25] study reported that the ERAS protocols were associated with mild post-operative complications in study group compared with the control group. In addition, Agarwal, et al [26] that the majority of study group had lesser complications than control group. From the perspective of the researcher, application of Enhanced Recovery Programmed reduced complications due to early remove of urinary catheter, early mobilization, diet and performing exercise as breathing, coughing and ankle exercise.…”

Section: Discussionmentioning

confidence: 98%

Effect of Enhanced Recovery Pathway on Hysterectomy Complications in Suez Canal University Hospital and General Hospital at Ismailia City

Atia¹,

Keshk²,

Abd-Allah³

2020

SJMH

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Background: The enhanced recovery pathway concept emerged as a multimodal approach directed at optimizing the patient experience, standardizing perioperative care, and improving surgical outcomes. Aim: to evaluate the effect of enhanced recovery pathway on hysterectomy complications for women in Suez Canal University Hospital and General Hospital in Ismailia City. Design: - A quasi-experimental study design was used in this study. Sample: - convenient sample consist of 132 women undergoing hysterectomy operation. Tool: - Structured interviewing questionnaire included questions personal and socio-demographic characteristics and -Obstetric, gynecological, surgical history and follow up assessment checklist. Results: - the majority of women in two groups were complained from bleeding (65.2% in control group and 60.6% in study group). 54.5 % of control group and 42.4% of study group had fibroid as a medical diagnosis. The highest frequency women (60.6% in control group and 43.9% in study group) had 1-6 month as time of current complained. The women in the study group were less likely to suffer from complications as fever, vaginal prolapse and pneumothorax compared to those in control group. Differences observed are statistically significant P= (0.023, 0.049, 0.004). Conclusion: The result of the study concluded that women undergoing hysterectomy operation who received enhanced recovery pathway protocol were more likely to decrease the incidence of post-operative complications than women who didn’t. Recommendation: - Health care settings should emphasize the importance of coordination between health care members relating to the application of the evidenced key elements of enhanced recovery pathway management regarding hysterectomy.

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Improved Outcomes in 394 Pancreatic Cancer Resections: the Impact of Enhanced Recovery Pathway

Abstract: CTRI/2015/01/005393 ( www.ctri.nic.in ).

Cited by 39 publications

References 32 publications

Society of Onco-Anaesthesia and Perioperative Care consensus guidelines for perioperative management of patients for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

Society of Onco-Anaesthesia and Perioperative Care consensus guidelines for perioperative management of patients for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)

Surgery for synchronous and metachronous single-organ metastasis of pancreatic cancer: a SEER database analysis and systematic literature review

Effect of Enhanced Recovery Pathway on Hysterectomy Complications in Suez Canal University Hospital and General Hospital at Ismailia City

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