中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 1
Jan.  2017
Turn off MathJax
Article Contents

Safety of fast track surgery in pancreaticoduodenectomy: a Meta-analysis

DOI: 10.3969/j.issn.1001-5256.2017.01.026
Research funding:

 

  • Published Date: 2017-01-20
  • Objective To investigate the safety and clinical effect of fast track surgery in pancreaticoduodenectomy,one of the most complex surgeries in general surgery. Methods The Chinese and foreign databases were searched for articles on the application of fast tract surgery in pancreaticoduodenectomy published from January 1994 to April 2016. Two researchers evaluated the quality of the articles which met the inclusion criteria and extracted related data. Stata 12. 0 software was used to analyze the overall incidence rate of complications and the incidence rates of pancreatic leakage and gastrointestinal emptying disorder,and the Begg rank correlation test and Egger linear regression method were used to investigate publication bias. Results The fast track surgery group had a significantly lower overall incidence rate of complications than the conventional group( RR = 0. 748,95% CI: 0. 680- 0. 824,P < 0. 001). There was no significant difference in the incidence rate of pancreatic leakage between the two groups( RR = 0. 894,95% CI: 0. 734- 1. 089,P = 0. 266). The fast track surgery group had a significantly lower incidence rate of gastrointestinal emptying disorder than the conventional group( RR = 0. 520,95% CI: 0. 400- 0.670,P < 0. 001). Conclusion Fast track surgery is safe and effective in pancreaticoduodenectomy,but the application of some measures in fast track surgery still needs more medical evidence.

     

  • loading
  • [1] WILMORE DW,KEHLET H.Management of patients in fast track surgery[J].BMJ,2001,322(7284):473-476.
    [2] China ERAS Group of CSPEN(Chinese Society for Parenteral and Enteral Nutrition).Chinese consensus of enhanced recovery after surgery for colorectal surgery(2015 edition)[J].Chin J Dig Surg,2015,14(8):606-608.(in Chinese)中华医学会肠外肠内营养学分会加速康复外科协作组.结直肠手术应用加速康复外科中国专家共识(2015版)[J].中华消化外科杂志,2015,14(8):606-608.
    [3] ZHANG WS,ZHONG WZ,LI B.Applied methodology for evidence-based medicine[M].Changsha:Central University Press,2014:238-244.(in Chinese)张天嵩,钟文昭,李博.实用循证医学方法学[M].长沙:中南大学出版社,2014:238-244.
    [4]SHAO Z,JIN G,HU XG,et al.Value of the concept of fasttrack surgery in pancreaticoduodenectomy[J].Chin J Surg,2014,52(3):208-209.(in Chinese)邵卓,金钢,胡先贵,等.快速康复外科理念在胰十二指肠切除术中的应用[J].中华外科杂志,2014,52(3):208-209.
    [5]WEI YH,HUANG Y,ZHAGN WX,et al.Value of fast track surgery principles in the perioperative management of whipple operation[J/CD].Chin J Clinicians:Electronic Edition,2015,9(9):1549-1553.(in Chinese)魏杨辉,黄耀,张卫星,等.快速康复外科理念在胰十二指肠切除术围手术期管理中的价值[J/CD].中华临床医师杂志:电子版,2015,9(9):1549-1553.
    [6]MA L,SHE ZF,YANG XF,et al.Clinical analysis of the concept of fast track surgery in pancreaticoduodenectomy[J/CD].Chin J Oper Proc Gen Surg:Electronic Edition,2015,9(4):256-258.(in Chinese)马路,折占飞,杨秀峰,等.快速康复外科理念在胰十二指肠切除术30例分析[J/CD].中华普外科手术学杂志:电子版,2015,9(4):256-258.
    [7]BRAGA M,PECORELLI N,ARIOTTI R,et al.Enhanced recovery after surgery pathway in patients undergoing pancreaticoduodenectomy[J].World J Surg,2014,38(11):2960-2966.
    [8]BALZANO G,ZERBI A,BRAGA M,et al.Fast-track recovery programme after pancreaticoduodenectomy reduces delayed gastric emptying[J].Br J Surg,2008,95(11):1387-1393.
    [9]MORALES SORIANO R,ESTEVE PREZ N,TEJADA GAVELA S,et al.Outcomes of an enhanced recovery after surgery programme for pancreaticoduodenectomy[J].Cir Esp,2015,93(8):509-515.
    [10]PARTELLI S,CRIPPA S,CASTAGNANI R,et al.Evaluation of an enhanced recovery protocol after pancreaticoduodenectomy in elderly patients[J].HPB(Oxford),2016,18(2):153-158.
    [11]JOLIAT GR,LABGAA I,PETERMANN D,et al.Cost-benefit analysis of an enhanced recovery protocol for pancreaticoduodenectomy[J].Br J Surg,2015,102(13):1676-1683.
    [12]STOWERS MD,MANUOPANGAI L,HILL AG,et al.Enhanced recovery after surgery in elective hip and knee arthroplasty reduces length of hospital stay[J].ANZ J Surg,2016,86(6):475-479.
    [13] ZHU DX,XU JM.Application of enhanced recovery after surgery in minimally invasive colorectal surgery[J].Chin J Gastrointestinal Surg,2016,19(3):256-259.(in Chinese)朱德祥,许剑民.加速康复外科在结直肠癌微创手术中的应用[J].中华胃肠外科杂志,2016,19(3):256-259.
    [14]JIANG HC,SUN B,WANG G.Fast-track surgery deserves more attention[J].Chin J Surg,2007,45(9):577-579.(in Chinese)姜洪池,孙备,王刚.快速康复外科的新理念值得重视[J].中华外科杂志,2007,45(9):577-579.
    [15]FA-SI-OEN P,ROUMEN R,BUITENWEG J,et al.Mechanical bowel preparation or not?Outcome of a multicenter,randomized trial in elective open colon surgery[J].Dis Colon Rectum,2005,48(8):1509-1516.
    [16]ZHU QD,ZHANG QY,ZENG QQ,et al.Efficacy of mechanical bowel preparation with polyethylene glycol in prevention of postoperative complications in elective colorectal surgery:a meta-analysis[J].Int J Colorectal Dis,2010,25(2):267-275.
    [17]SAHA AK,CHOWDHURY F,JHA AK,et al.Mechanical bowel preparation versus no preparation before colorectal surgery:a randomized prospective trial in a tertiary care institute[J].J Nat Sci Biol Med,2014,5(2):421-424.
    [18]HARISH L,KENNEDY EP,ROSS M,et al.Preoperative mechanical bowel preparation does not offer a benefit for patients who undergo pancreaticoduodenectomy[J].Surgery,2010,148(2):278-284.
    [19]CHOI YY,KIM J,SEO D,et al.Is routine nasogastric tube insertion necessary in pancreaticoduodenectomy?[J].J Korean Surg Soc,2011,81(4):257-262.
    [20]KUNSTMAN JW,KLEMEN ND,FONSECA AL,et al.Nasogastric drainage may be unnecessary after pancreaticoduodenectomy:a comparison of routine vs selective decompression[J].J Am Coll Surg,2013,217(3):481-488.
    [21]GIOVINAZZO F,BUTTURINI G,SALVIA R,et al.Drain management after pancreatic resection:state of the art[J].J Hepatobiliary Pancreat Sci,2011,18(6):779-784.
    [22]CAMILO CG,BRENNAN MF,MICHAEL D,et al.Operative drainage following pancreatic resection:analysis of 1122 patients resected over 5years at a single institution[J].Ann Surgery,2013,258(6):1051-1058.
    [23]KAMINSKY PM,MEZHIR JJ.Intraperitoneal drainage after pancreatic resection:a review of the evidence[J].J Surg Res,2013,184(2):925-930.
    [24]LASSEN K,COOLSEN MM,SLIM K,et al.Guidelines for perioperative care for pancreaticoduodenectomy:Enhanced Recovery After Surgery(ERAS)Society recommendations[J].Clin Nutr,2012,31(6):817-830.
    [25]YPSILANTIS E,PRASEEDOM RK.Current status of fast-track recovery pathways in pancreatic surgery[J].JOP,2009,10(6):646-650.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (2292) PDF downloads(478) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return