Sebastiano Mercadante1*, Fabrizio David1, Lucio Mandalà2, Patrizia Villari1, Pietro Mezzatesta2 and Alessandra Casuccio3
1Anesthesia and Intensive Care Unit, La Maddalena Cancer Center, Italy
2Department of Surgery, La Maddalena Cancer Center, Italy
3Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Italy
Aim: To assess the feasibility of a fast-track anesthesia protocol for hepatopancreatobiliary cancer surgery. Methods: Retrospective analysis of consecutive sample of patients who underwent hepatopancreatobiliary surgery for cancer for a period of 12 months in a high volume cancer center. Blended-anesthesia was performed for most patients who were then observed in a recovery room area until achieving a safety score. Results: Data of 163 patients were examined. Fifty-six and 107 patients underwent surgery for pancreatic cancer and liver surgery for primary tumor or metastases, respectively. Most patients were ASA 3. The mean durations of anesthesia and surgery were 322 min (SD 320) and 296 min (SD 133), respectively. Extubation was performed in the operating room in 125 patients. Postoperatory invasive ventilation was maintained in the recovery room in fifteen patients for a mean duration of 72.7 min (SD148.2). Only one patient was admitted to intensive care for 15 h. NIV was performed in three patients for a mean duration of 73.3 min (SD15.3).The mean recovery room staying was 79 min (SD 80). The mean hospital postoperative stay was a mean of 8.1 days (SD 5.7). No complications were found in 144 patients. Conclusion: A program of fast-track anesthesia with a short stay in recovery room allowed achieving an optimal outcome, limiting the costs of intensive care admission.
Anesthesia; Fast-track; Epidural Analgesia; Liver Surgery; Pancreatic Surgery; Cancer
Mercadante S, David F, Mandalà L, Villari P, Mezzatesta P, Casuccio A. Fast Track Anesthesia and Outcomes in Hepatopancreatobiliary Cancer Surgery: A Retrospective Analysis. Clin Surg. 2019; 4: 2610..