Effect of Enhanced Recovery After Surgery program on hospital stay and 90-day readmission after pancreaticoduodenectomy: a single, tertiary center experience in Korea.

PURPOSE: Despite increasing number of reports on Enhanced Recovery After Surgery program (ERAS) and readmission after pancreaticoduodenectomy (PD) from Western countries, there are very few reports on this topic from Asian countries. This study aimed to evaluate the effects of ERAS on hospital stay and readmission and to identify reasons and risk factors for readmission after PD. METHODS: This retrospective cohort study included 670 patients who underwent open PD from January 2003 to December 2017. The patients were classified into ERAS (n = 352) and non-ERAS (n = 318) groups. Patients' characteristics, perioperative outcomes, and readmission rates were compared. RESULTS: There were no significant differences in the postoperative complication rates between the groups. The mean postoperative hospital stay was significantly shorter in the ERAS group (24.5 vs. 18.0 days, P < 0.001), but the 90-day readmission rate was similar in the 2 groups (9.1% vs. 8.5%, P = 0.785). Complications associated with pancreatic fistula (42.4%) were the most common cause for readmission. In the multivariate analysis, diabetes mellitus (odds ratio [OR], 1.84; 95% confidence interval [CI], 1.05-3.24; P = 0.034), preoperative non-jaundice (OR, 0.45; 95% CI, 0.25-0.82; P = 0.009) and severe postoperative complications (OR, 4.12; 95% CI, 2.34-7.26; P < 0.001) were identified as risk factors for readmission. CONCLUSION: The results confirmed that the ERAS program for PD was beneficial in reducing postoperative stay without increasing readmission risks. To decrease readmission rates, prudent discharge planning and medical support should be considered in patients who experience severe complications.

Fast chemical recycling of carbon fiber reinforced plastic at ambient pressure using an aqueous solvent accelerated by a surfactant.

The properties of infusibility and insolubility in organic solvent of cured epoxy resin makes it difficult to recycle carbon fiber reinforced plastics (CFRP). We have reported the recycling of CFRPs using the oxidizing power of hydroxyl radicals generated from NaOCl solution. In our study, we used benzyltrimethylammonium bromide (BTAB) and sodium dodecyl sulfate (SDS) for the interfacial separation between the epoxy resin and carbon fibers (CF). The surfactant system maximized recycling efficiency in both pretreatment and the main reaction of the CFRP recycling process. In the second step, the reaction time to successfully reclaim the CFs was much shorter, only one hour, compared with the two-hour reaction time for the non-SDS process previously reported by us. Scanning electron microscope images and Raman analyses showed that the surface of the reclaimed CF (r-CFs) was clean and smooth without any defects, and there was no significant structural change compared to virgin CF (v-CFs). The tensile strength of r-CF was 3.42 GPa which is 96.9% of the v-CF. Thus, the CFRP recycling process using SDS not only results in r-CF with good mechanical and physical properties, but also increases recycling efficiency by reducing the time.