Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center
Objective:. The aim was to evaluate the sustainability of the pancreatic Enhanced Recovery After Surgery (ERAS) program and the effect of ERAS items on patient morbidity and hospital stay. Background:. The current ERAS guideline recommendations encompass 27 items to improve recovery after pancreatod...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health
2024-12-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000501 |
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| author | Alina S. Ritter, MD Thilo Welsch, MD, FACS, MBA Freya Brodersen, MSc Julia Auinger, MD Parisa Moll-Khosrawi, MD Mara R. Goetz, MD Jan Bardenhagen, MD Christine Nitschke, MD Tobias Schneider, BSc Björn Wellge, MD Anna Suling, PhD Faik G. Uzunoglu, MD Asmus Heumann, MD Felix Nickel, MD Thilo Hackert, MD Jakob R. Izbicki, MD |
| author_facet | Alina S. Ritter, MD Thilo Welsch, MD, FACS, MBA Freya Brodersen, MSc Julia Auinger, MD Parisa Moll-Khosrawi, MD Mara R. Goetz, MD Jan Bardenhagen, MD Christine Nitschke, MD Tobias Schneider, BSc Björn Wellge, MD Anna Suling, PhD Faik G. Uzunoglu, MD Asmus Heumann, MD Felix Nickel, MD Thilo Hackert, MD Jakob R. Izbicki, MD |
| author_sort | Alina S. Ritter, MD |
| collection | DOAJ |
| description | Objective:. The aim was to evaluate the sustainability of the pancreatic Enhanced Recovery After Surgery (ERAS) program and the effect of ERAS items on patient morbidity and hospital stay.
Background:. The current ERAS guideline recommendations encompass 27 items to improve recovery after pancreatoduodenectomy (PD).
Methods:. Patients who underwent pancreatic resection at the University Hospital Hamburg-Eppendorf between February 2016 and June 2023 were included. The datasets were retrospectively collected from a central database. The effects of individual ERAS items and compliance on morbidity and hospital stay were assessed by uni- and multivariable analyses.
Results:. In total, 594 patients who underwent PD (44.8%), distal pancreatectomy (14.6%), total pancreatectomy (17.8%), or other pancreatic resections (22.7%) were included. Of these, 90 patients (15.2%) achieved a high overall ERAS compliance of ≥70%. High compliance was associated with significantly less complications (Clavien–Dindo ≥ 3a), reduced 30-day mortality, and a shorter hospital stay. Early mobilization on the first postoperative day (POD1), restrictive intravenous fluid administration, and timely removal of urinary catheters were significant multivariable predictors for lower morbidity. Early mobilization on POD1 also correlated with reduced morbidity in the subcohort of PD cases.
Conclusions:. The pancreatic ERAS protocol can be sustainably implemented and applied to both, PD and non-PD cases. A high level of compliance with the ERAS protocol after pancreatic resections correlated with improved outcomes but was achieved by less than one-fifth of patients. Early mobilization on POD1 and restrictive fluid management were key indicators for optimized short-term outcomes. |
| format | Article |
| id | doaj-art-d5a2585025fd4a2cb50e5b6ade4d49d1 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-d5a2585025fd4a2cb50e5b6ade4d49d12025-01-24T09:18:58ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-12-0154e50110.1097/AS9.0000000000000501202412000-00031Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS CenterAlina S. Ritter, MD0Thilo Welsch, MD, FACS, MBA1Freya Brodersen, MSc2Julia Auinger, MD3Parisa Moll-Khosrawi, MD4Mara R. Goetz, MD5Jan Bardenhagen, MD6Christine Nitschke, MD7Tobias Schneider, BSc8Björn Wellge, MD9Anna Suling, PhD10Faik G. Uzunoglu, MD11Asmus Heumann, MD12Felix Nickel, MD13Thilo Hackert, MD14Jakob R. Izbicki, MD15From the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany† Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany† Department of Anesthesiology, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany§ Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyFrom the * Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, GermanyObjective:. The aim was to evaluate the sustainability of the pancreatic Enhanced Recovery After Surgery (ERAS) program and the effect of ERAS items on patient morbidity and hospital stay. Background:. The current ERAS guideline recommendations encompass 27 items to improve recovery after pancreatoduodenectomy (PD). Methods:. Patients who underwent pancreatic resection at the University Hospital Hamburg-Eppendorf between February 2016 and June 2023 were included. The datasets were retrospectively collected from a central database. The effects of individual ERAS items and compliance on morbidity and hospital stay were assessed by uni- and multivariable analyses. Results:. In total, 594 patients who underwent PD (44.8%), distal pancreatectomy (14.6%), total pancreatectomy (17.8%), or other pancreatic resections (22.7%) were included. Of these, 90 patients (15.2%) achieved a high overall ERAS compliance of ≥70%. High compliance was associated with significantly less complications (Clavien–Dindo ≥ 3a), reduced 30-day mortality, and a shorter hospital stay. Early mobilization on the first postoperative day (POD1), restrictive intravenous fluid administration, and timely removal of urinary catheters were significant multivariable predictors for lower morbidity. Early mobilization on POD1 also correlated with reduced morbidity in the subcohort of PD cases. Conclusions:. The pancreatic ERAS protocol can be sustainably implemented and applied to both, PD and non-PD cases. A high level of compliance with the ERAS protocol after pancreatic resections correlated with improved outcomes but was achieved by less than one-fifth of patients. Early mobilization on POD1 and restrictive fluid management were key indicators for optimized short-term outcomes.http://journals.lww.com/10.1097/AS9.0000000000000501 |
| spellingShingle | Alina S. Ritter, MD Thilo Welsch, MD, FACS, MBA Freya Brodersen, MSc Julia Auinger, MD Parisa Moll-Khosrawi, MD Mara R. Goetz, MD Jan Bardenhagen, MD Christine Nitschke, MD Tobias Schneider, BSc Björn Wellge, MD Anna Suling, PhD Faik G. Uzunoglu, MD Asmus Heumann, MD Felix Nickel, MD Thilo Hackert, MD Jakob R. Izbicki, MD Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center Annals of Surgery Open |
| title | Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center |
| title_full | Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center |
| title_fullStr | Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center |
| title_full_unstemmed | Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center |
| title_short | Impact of Enhanced Recovery After Surgery Protocol Compliance on Outcome After Pancreatic Surgery: Results From a Certified ERAS Center |
| title_sort | impact of enhanced recovery after surgery protocol compliance on outcome after pancreatic surgery results from a certified eras center |
| url | http://journals.lww.com/10.1097/AS9.0000000000000501 |
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