Influence of an enhanced recovery programme on clinical outcomes and health-related quality of life after pancreaticoduodenectomy ad modum Whipple - an explorative and comparative single-centre study.

IF 1.6 3区 医学 Q2 SURGERY
Thomas Andersson, My Engström, Johanna Wennerblom, Hanna Gyllensten, Kristofer Bjerså
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引用次数: 0

Abstract

Background: The introduction of enhanced recovery programmes (ERP) in pancreatic surgery has significantly improved clinical outcomes by decreasing the length of hospital stay, cost and complications without increasing readmissions and reoperations. To complement evidence on these outcomes, there is a need to explore patients' perspectives of a structured ERP. Therefore, this study aimed to explore the health-related quality of life (HRQoL) of patients before and after implementing ERP in pancreaticoduodenectomy ad modum Whipple (PD) at a regional surgical centre.

Method: This was an explorative and comparative single-centre study in Sweden. A prospective cohort receiving ERP was included between October 2019 and December 2022 (n = 73) and was compared with a retrospective pre-ERP cohort between October 2011 and December 2013 (n = 65). EQ-5D, the European Organization for Research and Treatment of Cancer (EORCT) Quality of Life Questionnaire Cancer 30 items (QOL-C30), and EORCT Quality of Life Questionnaire pancreatic cancer module (QOL-PAN26) were collected preoperatively and at three and six months postoperatively. Demographic and clinical variables were collected from patient charts. Complications were expressed using the Clavien-Dindo Classification and the Comprehensive Complications Index (CCI).

Results: There were no significant differences in general health, cancer- or disease-specific HRQoL between the pre-ERP and ERP cohorts. Length of stay was significantly shorter in the ERP cohort (16 vs. 11 days; p < 0.001). There was no significant difference in CCI.

Conclusion: No significant differences were found in the HRQoL of patients who participated in an ERP compared to those who did not. However, a significant decrease in LoS was found when ERP was applied.

Trial registration: Not applicable.

增强康复方案对胰十二指肠切除术后临床结果和健康相关生活质量的影响-一项探索性和比较单中心研究
背景:在胰腺手术中引入增强恢复方案(ERP),通过减少住院时间、费用和并发症而不增加再入院和再手术,显著改善了临床结果。为了补充这些结果的证据,有必要探索患者对结构化ERP的看法。因此,本研究旨在探讨区域外科中心胰十二指肠切除术后Whipple (PD)实施ERP前后患者的健康相关生活质量(HRQoL)。方法:这是一项在瑞典进行的探索性、比较性单中心研究。纳入2019年10月至2022年12月期间接受ERP治疗的前瞻性队列(n = 73),并与2011年10月至2013年12月期间接受ERP治疗的回顾性队列(n = 65)进行比较。术前、术后3个月和6个月收集EQ-5D、欧洲癌症研究与治疗组织(EORCT)生活质量问卷癌症30项(QOL-C30)和EORCT生活质量问卷胰腺癌模块(QOL-PAN26)。从患者图表中收集人口统计学和临床变量。并发症采用Clavien-Dindo分类法和综合并发症指数(CCI)表示。结果:在ERP前和ERP队列之间,一般健康状况、癌症或疾病特异性HRQoL没有显著差异。ERP组的住院时间明显更短(16天vs. 11天;p结论:与未参加ERP的患者相比,参加ERP的患者的HRQoL无显著差异。然而,当应用ERP时,发现LoS显著降低。试验注册:不适用。
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来源期刊
BMC Surgery
BMC Surgery SURGERY-
CiteScore
2.90
自引率
5.30%
发文量
391
审稿时长
58 days
期刊介绍: BMC Surgery is an open access, peer-reviewed journal that considers articles on surgical research, training, and practice.
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