Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta-analysis

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Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta-analysis

Kuemmerli, Christoph (författare): University Hospital Southampton

Balzano, Gianpaolo (författare): Vita-Salute San Raffaele University

Bouwense, Stefan A. (författare): Yukioka Hospital

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Braga, Marco (författare): University of Milano-Bicocca

Coolsen, Mariëlle (författare): Yukioka Hospital

Daniel, Sara K. (författare): University of Washington

Dervenis, Christos (författare): Metropolitan Hospital

Falconi, Massimo (författare): Vita-Salute San Raffaele University

Hwang, Dae Wook (författare): University of Ulsan

Kagedan, Daniel J. (författare): University of Toronto

Kim, Song Cheol (författare): University of Ulsan

Lavu, Harish (författare)

Nussbaum, Daniel (författare): Duke University Medical Center

Partelli, Stefano (författare): Vita-Salute San Raffaele University

Passeri, Michael J. (författare): Carolinas Medical Center

Pecorelli, Nicolò (författare): Vita-Salute San Raffaele University

Pillarisetty, Venu G. (författare): University of Washington

Pucci, Michael J. (författare)

Sutcliffe, Robert P. (författare): University Hospitals Birmingham

Tingstedt, Bobby (författare): Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

van der Kolk, Marion (författare): Radboud University Medical Center

Vrochides, Dionisios (författare): Carolinas Medical Center

Armstrong, Misha (författare): Memorial Sloan-Kettering Cancer Center

Wei, Alice (författare): Memorial Sloan-Kettering Cancer Center

Williamsson, Caroline (författare): Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lever-, pankreas- och gallvägskirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Hepato-Pancreato-Biliary Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital

Yeo, Charles J. (författare)

Zani, Sabino (författare): Duke University Medical Center

Zouros, Efstratios (författare): Athens General Hospital

Rozzini, Renzo (författare)

Abu Hilal, Mohammed (författare): University Hospital Southampton

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Engelska.
Ingår i: Journal of Hepato-Biliary-Pancreatic Sciences. - 1868-6974.

Relaterad länk:: http://dx.doi.org/10...; visa fler...; https://lup.lub.lu.s...; https://doi.org/10.1...; visa färre...

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Background: This meta-analysis investigated the effects of enhanced recovery after surgery (ERAS) protocols compared to conventional care on postoperative outcomes in patients aged 70 years or older undergoing pancreatoduodenectomy (PD). Methods: Five databases were systematically searched. Comparative studies with available individual patient data (IPD) were included. The main outcomes were postoperative morbidity, length of stay, readmission and postoperative functional recovery elements. To assess an age-dependent effect, the group was divided in septuagenarians (70–79 years) and older patients (≥80 years). Results: IPD were obtained from 15 of 31 eligible studies comprising 1109 patients. The overall complication and major complication rates were comparable in both groups (OR 0.92 [95% CI: 0.65–1.29], p =.596 and OR 1.22 [95% CI: 0.61–2.46], p =.508). Length of hospital stay tended to be shorter in the ERAS group compared to the conventional care group (−0.14 days [95% CI: −0.29 to 0.01], p =.071) while readmission rates were comparable and the total length of stay including days in hospital after readmission tended to be shorter in the ERAS group (−0.28 days [95% CI: −0.62 to 0.05], p =.069). In the subgroups, the length of stay was shorter in octogenarians treated with ERAS (−0.36 days [95% CI: −0.71 to −0.004], p =.048). The readmission rate increased slightly but not significantly while the total length of stay was not longer in the ERAS group. Conclusion: ERAS in the elderly is safe and its benefits are preserved in the care of even in patients older than 80 years. Standardized care protocol should be encouraged in all pancreatic centers.

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kirurgi

Artiklar i publikationen: Journal of Hepat ...

Av lärosätet: Lunds universitet

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Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta-analysis

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