International journal of surgery
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Review
Enhanced recovery after surgery for pancreaticoduodenectomy: Review of current evidence and trends.
Pancreaticoduodenectomy (PD) remains a morbid procedure. The use of Enhanced Recovery After Surgery (ERAS) pathways has proven to reduce care time and post-operative complications after colorectal surgery. There is a high potential for reducing morbidity associated with PD by utilizing ERAS. ⋯ The purpose of this review is to examine the current evidence for ERAS in preoperative, intraoperative and post-operative setting of care for PD patients and to propose ERAS evidence-based protocol for patients undergoing PD. Evidence indicates that ERAS protocols may be implemented in PD without compromising patient safety or increasing length of stay. ERAS in the context of PD should be standardized based on the best available evidence, and ERAS programmes involving multiple centers should be performed.
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The aim of this study was to evaluate the clinical and radiologic results of multisegmental transforaminal enlarged decompression (TED) plus posterior pedicle screw fixation in the treatment of multilevel lumbar spinal canal stenosis (LSCS) with lumbar instability (MLSCSI). ⋯ Satisfactory clinical and radiological outcomes can be achieved with the use of multisegmental TED plus lumbar fusion for the treatment of MLSCSI. This technique can reduce surgically induced instability and obviously improve the symptoms and signs of the patients, suggesting a safe and effective therapeutic procedure for MLSCSI.