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Enhanced Recovery After Surgery ERAS

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https://www.readbyqxmd.com/read/27933266/nonstrict-and-individual-enhanced-recovery-after-surgery-eras-in-partial-hepatectomy
#1
Xingwei Xu, Yingbin Wang, Tao Feng, Xin Zhao, Yannian Liao, Wu Ji, Jieshou Li
BACKGROUND: We aimed to evaluate postoperative recovery and short-term outcomes of patients undergoing partial hepatectomy managed with a nonstrict and individual enhanced recovery after surgery (ERAS) program. METHODS: A retrospective analysis of 168 partial hepatectomy patients in our institution was included. The discharged day and the respective impact of element application throughout the duration were analyzed. RESULTS: When all the required elements of ERAS were fully implemented, the median discharge day was 6...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27922866/quality-and-safety-in-health-care-part-xix-variants-of-the-eras-program
#2
Jay A Harolds
The integrated recovery pathway is a variant of the enhanced recovery pathway after surgery program, which saw a further decrease in complications and mean length of stay after a change in culture was instituted with more accountability of the staff to following the pathway. This was accomplished using a team-based comprehensive unit-based safety program. It has also been found that another variant of the enhanced recovery pathway after surgery program had a further improvement of patient outcomes after instituting a "preventive surgical site infection bundle...
December 3, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27900463/a-model-for-lymphocyte-activation-in-open-versus-laparoscopic-surgery-in-colorectal-cancer-patients-in-enhanced-recovery-after-surgery-eras-protocols
#3
Ana Belén Martínez, J Longás, J M Ramírez
PURPOSE: Given the high mortality and morbidity associated with colon cancer worldwide and the advantages inherent to the use of the laparoscopy technique with respect to open surgery in oncological colorectal surgery, a study was designed to observe and compare the lymphocyte activation model between open surgery (OS) and laparoscopic surgery (LS) for this type of patient as part of an ERAS protocol. METHODS: A prospective study was conducted with 38 patients who underwent surgery due to colorectal disease and were included in an ERAS protocol...
November 30, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27884220/multimodal-pain-management-for%C3%A2-enhanced-recovery-reinforcing-the-shift-from-traditional-pathways-through-nurse-led-interventions
#4
Robert Montgomery, Sharon A McNamara
Despite recent advances in perioperative patient care, postsurgical pain continues to be undermanaged. There is increasing acceptance of the concept that effective postsurgical pain management is best achieved through combined use of more than one analgesic agent or technique, and overreliance on opioids produces unwanted side effects limiting their utility. Accordingly, a balanced, multimodal approach to pain management within the larger framework of an Enhanced Recovery After Surgery (ERAS) pathway has become standard at many institutions for perioperative care, to control postsurgical pain, reduce opioid-related adverse events, hasten postsurgical recovery, and shorten length of hospital stay...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27882418/compliance-with-guidelines-of-enhanced-recovery-after-surgery-in-elderly-patients-undergoing-gastrectomy
#5
Oh Jeong, Young Kyu Park, Mi Ran Jung, Seong Yeob Ryu
BACKGROUND: Enhanced recovery after surgery (ERAS) aims at expediting postoperative recovery by implementing specific strategies in perioperative management. However, the tolerance to such fast-tracking protocols is under debate, especially in elderly patients. We aimed to investigate rate of compliance with the main ERAS guidelines in elderly gastrectomy patients. METHODS: Using data for 168 gastric cancer patients who underwent ERAS after gastrectomy as part of Clinical Trial NCT01653496, we calculated the rates of compliance with nine main ERAS guidelines and compared the compliance rates of elderly (≥70 years) and non-elderly (<70 years) patients...
November 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27878754/efficiency-and-safety-effects-of-applying-eras-protocols-to-bariatric-surgery-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis-of-evidence
#6
REVIEW
Preet Mohinder Singh, Rajesh Panwar, Anuradha Borle, Basavana Goudra, Anjan Trikha, Bart A van Wagensveld, Ashish Sinha
Application of the enhanced recovery after surgery (ERAS) to the bariatric surgical procedures is at its early stages with little consolidated evidence. This meta-analysis evaluates present literature and indicates pathways for development of evidence-based standardized ERAS protocols for bariatric surgery. Comparative trials between ERAS and conventional bariatric surgery published till June 2016 were searched in the medical database. Comparisons were made for length of stay (LOS), readmission, complications (major/minor), and reoperation rates...
November 23, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27875094/laparoscopic-radical-gastrectomy-for-resectable-advanced-gastric-cancer-within-enhanced-recovery-programs-a-prospective-randomized-controlled-trial
#7
Xia Mingjie, Zhang Luyao, Tang Ze, Zhao YinQuan, Wang Quan
BACKGROUND: Enhanced recovery programs have become an important focus of perioperative management. A few studies have demonstrated the efficacy of an enhanced recovery after surgery (ERAS, which includes optimized pain control, restricted I.V. fluids, early initiation of postoperative oral feeding, and enforced mobilization) protocol in patients undergoing radical gastrectomy. We investigated the feasibility and safety of laparoscopic radical gastrectomy within ERAS programs. METHODS: In this single-center prospective randomized controlled trial conducted between September 2013 and August 2014, 149 consecutive locally advanced gastric cancer patients (T2-4, any N, M0) diagnosed by the CT scanning were allocated to either ERAS group (N = 73) or conventional pathway group (N = 76)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27865279/enhanced-recovery-pathways-in-pancreatic-surgery
#8
REVIEW
Joshua G Barton
Enhanced recovery after surgery (ERAS) protocols were first introduced to help recovery after colorectal surgery. They have now been applied to multiple surgical specialties, including pancreatic surgery. ERAS protocols in pancreatic surgery have been shown to decrease length of stay and possibly postoperative morbidity.
December 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/27855087/impact-of-weekday-surgery-on-application-of-enhanced-recovery-pathway-a-retrospective-cohort-study
#9
Benoît Romain, Fabian Grass, Valérie Addor, Nicolas Demartines, Martin Hübner
OBJECTIVE: To compare the enhanced recovery after surgery (ERAS) protocol compliance and clinical outcomes depending on the weekday of surgery. SETTINGS: Cohort of consecutive non-selected patients undergoing elective colorectal surgery from January 2012 to March 2015. This retrospective analysis of our prospective database compared patients operated early in the week (Monday and Tuesday) with patients operated in the second half (late: Thursday, Friday). PRIMARY OUTCOME MEASURES: Compliance with the ERAS protocol, functional recovery, complications and length of stay...
October 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27822725/enhanced-recovery-after-surgery-programs-improve-patient-outcomes-and-recovery-a-meta-analysis
#10
Christine S M Lau, Ronald S Chamberlain
INTRODUCTION: Enhanced recovery after surgery (ERAS) programs have been developed to improve patient outcomes, accelerate recovery after surgery, and reduce healthcare costs. ERAS programs are a multimodal approach, with interventions during all stages of care. This meta-analysis examines the impact of ERAS programs on patient outcomes and recovery. METHODS: A comprehensive search of all published randomized control trials (RCTs) assessing the use of ERAS programs in surgical patients was conducted...
November 7, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27820740/enhanced-recovery-after-bariatric-surgery
#11
Adrian Alvarez, Basavana G Goudra, Preet Mohinder Singh
PURPOSE OF REVIEW: Enhanced recovery after surgery (ERAS) methodology has demonstrated consistent benefits in patients undergoing colorectal, urological and thoracic surgeries. Principles of these protocols and their advantages are expected to extend into other surgical specialties such as bariatric surgery. In this review, we summarize the components of ERAS protocols for bariatric surgery and present the evidence on the emerging role of ERAS principles in obese patients. RECENT FINDINGS: Many recent trials have evaluated ERAS protocols for bariatric surgery...
November 4, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27817086/enhanced-recovery-after-bariatric-surgery-systematic-review-and-meta-analysis
#12
REVIEW
Piotr Małczak, Magdalena Pisarska, Major Piotr, Michał Wysocki, Andrzej Budzyński, Michał Pędziwiatr
Enhanced recovery after surgery (ERAS) protocol is well established in many surgical disciplines and leads to a decrease in the length of hospital stay and morbidity. Multimodal protocols have also been introduced to bariatric surgery. This review aims to evaluate the current literature on ERAS in obesity surgery and to conduct a meta-analysis of primary and secondary outcomes. MEDLINE, Embase, Scopus and Cochrane Library were searched for eligible studies. Key journals were hand-searched. We analysed data up to May 2016...
November 6, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27807815/eras-and-pancreatic-surgery-a-review
#13
REVIEW
J Perinel, M Adham
Pancreatic surgery is still considered as a high-risk abdominal surgery. While the mortality rate is low, the morbidity remains high ranging from 30 to 60%. In 2012, the ERAS study group published the official recommendations to implement the enhanced recovery after surgery (ERAS) program in patients undergoing PD. Non-randomized studies have shown that ERAS was safe and feasible. They reported a significantly shortened LOS with lower morbidity in ERAS group. However, the level of evidence remains low due to absence of randomized study and because of a substantial heterogeneity in the content of ERAS protocols...
September 2016: Updates in Surgery
https://www.readbyqxmd.com/read/27806769/-the-possibility-and-feasibility-of-implementation-of-enhanced-recovery-after-surgery-program-in-pancreatic-surgery
#14
Y Miao
Although the concept of enhanced recovery after surgery(ERAS)had been raised for nearly 20 years, the application of ERAS in pancreatic surgery is still restricted because of great trauma and high incidence of postoperative complications.ERAS have demonstrated significantly accelerated postoperative recovery in pancreatic resections.Large amounts of researches confirmed that using an ERAS protocol in pancreatic surgery could help reduce overall morbidity and shorten postoperative length of hospital stay and reduce in-hospital costs...
November 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27783027/eras-protocol-reduces-il-6-secretion-in-colorectal-laparoscopic-surgery-results-from-a-randomized-clinical-trial
#15
Giulio Mari, Jacopo Crippa, Andrea Costanzi, Michele Mazzola, Michele Rossi, Dario Maggioni
BACKGROUND: Enhanced Recovery After Surgery (ERAS) program applied to colorectal laparoscopic surgery is well known to reduce hospitalization improving short-terms outcomes. Its goal is to minimize the surgical stress response in order to maintain the physiological homeostasis altered by surgery. However, there is little knowledge about the involved dynamics in the reduction of the surgical stress that these programs allow. The primary aim of this study was to compare the level of immune and nutritional serum investigators across surgery in patients undergoing elective colorectal laparoscopic surgery within an ERAS protocol or according to a standard care program...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27780772/pre-and-postoperative-stoma-education-and-guidance-within-an-enhanced-recovery-after-surgery-eras-programme-reduces-length-of-hospital-stay-in-colorectal-surgery
#16
H M Forsmo, F Pfeffer, A Rasdal, H Sintonen, H Körner, C Erichsen
INTRODUCTION: Stoma formation delays discharge after colorectal surgery. Stoma education is widely recommended, but little data are available regarding whether educational interventions are effective. The aim of this prospective study was to investigate whether an enhanced recovery after surgery (ERAS) programme with dedicated ERAS and stoma nurse specialists focusing on counselling and stoma education can reduce the length of hospital stay, re-admission, and stoma-related complications and improve health-related quality of life (HRQoL) compared to current stoma education in a traditional standard care pathway...
October 22, 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27770249/enhanced-recovery-eras-for-elderly-a-safe-and-beneficial-pathway-in-colorectal-surgery
#17
J Slieker, P Frauche, J Jurt, V Addor, C Blanc, Nicolas Demartines, M Hübner
BACKGROUND: Enhanced recovery after surgery (ERAS) pathway includes recovery goals requiring active participation of the patients; this may be perceived as "aggressive" care in older patients. The aim of the present study was to assess whether ERAS was feasible and beneficial in older patients. METHODS: Since June 2011, all consecutive colorectal patients were included in an ERAS pathway and documented in a dedicated prospective database. This retrospective analysis included 513 patients, 311 younger patients (<70 years) and 202 older patients (≥70 years)...
October 21, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27766398/enhanced-recovery-program-in-high-risk-patients-undergoing-colorectal-surgery-results-from-the-perioperative-italian-society-registry
#18
Marco Braga, Nicolò Pecorelli, Marco Scatizzi, Felice Borghi, Giancarlo Missana, Danilo Radrizzani
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways represent the optimal approach for patients undergoing colorectal surgery. Elderly or low physical status patients have been often excluded from ERAS pathways because considered at high risk. The aim of this study is to assess the adherence to ERAS protocol and its impact on short-term postoperative outcome in patients with different surgical risk undergoing elective colorectal resection. METHODS: Prospectively collected data entered in an electronic Italian registry specifically designed for ERAS were reviewed...
October 20, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27764038/quality-and-safety-in-health-care-part-xviii-improving-outcomes-in-colorectal-surgery
#19
Jay A Harolds
An important way to improve outcomes after colorectal surgery is to follow the recommendations of the enhanced recovery pathway after surgery (ERAS). The ERAS guidelines are recommendations that address certain aspects of what should be done before surgery, in the operating room, and following surgery. There is a substantial fall in complications and a decrease in the length of stay for the patient if the recommendations are followed. Elements of the ERAS program are now being adopted for other surgical procedures besides colorectal surgery...
January 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27753710/implementation-of-the-spanish-national-enhanced-recovery-program-eras-in-bariatric-surgery-a-pilot-study
#20
Jaime Ruiz-Tovar, Pablo Royo, José L Muñoz, Manuel Duran, Elisabeth Redondo, Jose M Ramirez
INTRODUCTION: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery. PATIENTS AND METHODS: A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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