التفاصيل البيبلوغرافية
| العنوان: |
Are enhanced recovery protocols after pancreatoduodenectomy still efficient when applied in elderly patients? A systematic review and individual patient data meta‐analysis. |
| المؤلفون: |
Kuemmerli, Christoph, Balzano, Gianpaolo, Bouwense, Stefan A., Braga, Marco, Coolsen, Mariëlle, Daniel, Sara K., Dervenis, Christos, Falconi, Massimo, Hwang, Dae Wook, Kagedan, Daniel J., Kim, Song Cheol, Lavu, Harish, Nussbaum, Daniel, Partelli, Stefano, Passeri, Michael J., Pecorelli, Nicolò, Pillarisetty, Venu G., Pucci, Michael J., Sutcliffe, Robert P., Tingstedt, Bobby |
| المصدر: |
Journal of Hepato -- Biliary -- Pancreatic Sciences; May2024, Vol. 31 Issue 5, p308-317, 10p |
| مستخلص: |
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. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of Hepato -- Biliary -- Pancreatic Sciences is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
