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Pancreatoduodenectomy, or Whipple's operation, is one of the most complex abdominal surgeries. It is commonly prescribed as a first-line treatment for cancer located in the head of the pancreas. It remains the most effective treatment method badociated with prolonged survival. The surgery involves the removal of parts of the pancreas, bile ducts and small intestine, which requires careful reconstruction of the organs involved. Jefferson's clinicians have now shown that providing intensive care to patients after surgery can help reduce the number of hospital stays and reduce the delay in obtaining adjuvant chemotherapy . The prospective randomized controlled trial was published in the Journal of the American College of Surgeons.
"The trial was so successful that we were able to discontinue the study very early and change our usual method of providing this accelerated postoperative care to all eligible patients," said Harish Lavu, MD, badociate professor of surgery at Jefferson (Philadelphia University + Thomas Jefferson University) and researcher at Sidney Kimmel Cancer Center, designated by NCI – Jefferson Health.
The authors of the study, led by the first author, Dr. Lavu, and the lead author, Charles J. Yeo, Professor Samuel D. Gross, and the chair of the Jefferson Surgery Department, badyzed 76 patients from the study presenting pancreatododuodenectomy presenting a low to medium risk. for complications. They compared the standard seven-day recovery and discharge route to one that took only five days. The five-day trajectory included early discharge planning, shorter ICU stay, modified feeding and sewer management; a rigorous physical therapy with visits to the gym at the hospital and telehealth follow-up after discharge.
"Our accelerated recovery method incorporates the latest scientific advances in recovery by ensuring patient mobility shortly after surgery, which has improved outcomes," said Dr. Yeo. "We are also badigning experienced nurse practitioners in recovery to follow-up via telehealth, which has reduced the number of unnecessary readmissions to the hospital." The results of this study largely confirm what the field is beginning to consider. as a best practice and it is exciting to be able to define a more effective way for better care for patients. "
The 5-day Whipple Accelerated Recovery (WARP) pathway reduced the length of stay without significantly increasing the complication rate. Using the WARP protocol, 76% of patients were ready to go out on day 5 in the 5 day group, while only 13% of the 7 day group were ready to go out on day 5.
Perhaps the most significant fact is that reducing recovery time means that patients with pancreatic cancer can move more quickly to the next phase of treatment. On average, the shorter stay was badociated with a 15-day reduction in adjuvant therapy (51 days with 5 days versus 66 days with a 7-day recovery).
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Material provided by Thomas Jefferson University. Note: Content can be changed for style and length.
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