Experience of application of accelerated rehabilitation programs in patients with distal pancreas resection

• Published in: Vestnik hirurgii im. I.I. Grekova Vol. 179; no. 4; pp. 62 - 71
• Main Authors: Koshel, A. P., Drozdov, E. S., Klokov, S. S., Dibina, T. V., Nustafaev, R. S., Provotorov, А. S.
• Format: Journal Article
• Language: English; Russian
• Published: Pavlov First Saint Petersburg State Medical University 08-11-2020
• Subjects: distal resection; enhanced recovery; pancreas; pancreatic fistula
• ISSN: 0042-4625; 2686-7370
• DOI: 10.24884/0042-4625-2020-179-4-62-71

Introduction. The implementation of ERAS (Enhanced recovery after surgery) protocols has been shown to be effective in orthopedics, bariatric and colorectal surgery. However, the safety and feasibility of implementing accelerated rehabilitation protocols in patients underwent distal pancreatic resection is not well studied.The objective was to analyze the results of the application of accelerated rehabilitation protocols in patients underwent distal pancreatic resection.Methods and materials. A retrospective - prospective, single-center study was conducted. The study included 60 patients. Patients were divided into two groups (control group - 30 patients, perioperative management was carried out according to standard methods and the main group - 30 patients, perioperative management was carried out according to the accelerated rehabilitation protocol). All patients included in the study underwent distal pancreas resection.Results. Patients in the analyzed groups were comparable by gender, age, body mass index, and ASA score. The frequency and severity of postoperative complications in the compared groups was comparable. The frequency of early activation of patients was significantly higher in the main group (86.7 vs 56.7; p<0.001). Postoperative recovery of gastrointestinal tract function was faster in the main group ((2.4±0.9) vs (3.6±1.2); p<0.001). The total duration of the postoperative hospital bed in the compared groups was comparable ((12.9±6.8) vs (14.1±6.1); p=0.2), however, when analyzing a subgroup of patients without complications and with minor complications, the differences in the duration of the postoperative hospital bed in the main and control groups was statistically significant ((8.9±3.6) and (11.7±3.4), respectively, p=0.01).Conclusion. The study showed the safety and effectiveness of implementing accelerated rehabilitation protocols in patients underwent distal pancreatic resection.