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Enhanced Recovery After Surgery ERAS

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https://www.readbyqxmd.com/read/29129637/a-multicentre-qualitative-study-assessing-implementation-of-an-enhanced-recovery-after-surgery-program
#1
D Martin, D Roulin, F Grass, V Addor, O Ljungqvist, N Demartines, M Hübner
BACKGROUND & AIMS: The existence of enhanced recovery specific guidelines (ERAS) is not enough to change patient management practice since many barriers exist to successful ERAS implementation. The present survey aimed to analyse motivations for implementation as well as encountered difficulties and challenges. Further, relevance and importance of perioperative care items and postoperative recovery targets were assessed. METHODS: A multicentre qualitative study was conducted between August and December 2016 among surgeons, anaesthesiologists and nurses from implemented ERAS centres in Switzerland (n = 16) and Sweden (n = 14)...
October 31, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29124853/intracorporeal-robotic-assisted-radical-cystectomy-together-with-an-enhanced-recovery-programme-improves-postoperative-outcomes-by-aggregating-marginal-gains
#2
Wei Shen Tan, Mae-Yen Tan, Benjamin W Lamb, Ashwin Sridhar, Anna Mohammed, Hilary Baker, Senthil Nathan, Timothy Briggs, Melanie Tan, John D Kelly
OBJECTIVE: To assess the cumulative effect of an enhanced recovery after surgery (ERAS) pathway and a minimally invasive RARC with intracorporeal urinary diversion (iRARC) in comparison to open radical cystectomy (ORC) on hospital length of stay (LOS) and perioperative outcomes. MATERIALS & METHODS: Between Feb 2009 and Oct 2017, 304 radical cystectomy cases were performed at a single institution (54 ORC, 250 RARC). Data were prospectively collected. We identified 45 consecutive ORC cases performed without ERAS before the commencement of the RARC programme (Cohort A), 50 consecutive iRARC cases performed without ERAS (Cohort B) and 40 iRARC cases with ERAS (Cohort C)...
November 10, 2017: BJU International
https://www.readbyqxmd.com/read/29119528/perioperative-factors-predicting-prolonged-postoperative-ileus-after-major-abdominal-surgery
#3
Kotaro Sugawara, Yoshikuni Kawaguchi, Yukihiro Nomura, Yusuke Suka, Keishi Kawasaki, Yukari Uemura, Daisuke Koike, Motoki Nagai, Takatoshi Furuya, Nobutaka Tanaka
BACKGROUND: Prolonged postoperative ileus (PPOI) is among the common complications adversely affecting postoperative outcomes. Predictors of PPOI after major abdominal surgery remain unclear, although various PPOI predictors have been reported in patients undergoing colorectal surgery. This study aimed to devise a model for stratifying the probability of PPOI in patients undergoing abdominal surgery. METHODS: Between 2012 and 2013, 841 patients underwent major abdominal surgery after excluding patients who underwent less-invasive abdominal surgery, ileus-associated surgery, and emergency surgery...
November 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29116394/a-prospective-randomized-pilot-study-evaluating-an-eras-protocol-versus-a-standard-protocol-for-patients-treated-with-radical-cystectomy-and-urinary-diversion-for-bladder-cancer
#4
Sebastian Karl Frees, Jonathan Aning, Peter Black, Werner Struss, Robert Bell, Claudia Chavez-Munoz, Martin Gleave, Alan I So
PURPOSE: There is a lack of evidence demonstrating the benefits of using enhanced recovery after surgery protocols (ERAS). Here, we propose to use a randomized clinical pilot study to demonstrate the benefits and feasibility of implementing ERAS versus standard protocols (SP) in patients undergoing radical cystectomy (RC) and urinary diversion. METHODS: 27 consecutive patients undergoing RC were included in the study. 12 patients were prospectively randomized to follow an ERAS protocol and 15 patients followed an SP...
November 7, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29099565/implementation-of-an-enhanced-recovery-after-surgery-program-for-colorectal-surgery-at-a-community-teaching-hospital
#5
Mallory S Bray, Angela L Appel, Kara J Kallies, Andrew J Borgert, Brittany A Zinnel, Stephen B Shapiro
INTRODUCTION: Perioperative programs aimed at decreasing surgical stress to colorectal patients can reduce hospital length of stay and morbidity while improving the patient’s perception of the surgical experience. Our goal was to transform patient care from a perioperative platform based on individual physician and nurse choice to a standardized evidence-based Enhanced Recovery After Surgery (ERAS) protocol for all patients undergoing elective colorectal resections. METHODS: An institutional review board-approved retrospective review was performed for the first 12 months of ERAS protocol-driven patient care in 2014 and compared to the prior 12 months (2013) of individual choice managed care...
February 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29081374/enhanced-recovery-after-surgery-for-pancreaticoduodenectomy-review-of-current-evidence-and-trends
#6
REVIEW
Xiequn Xu, Chaoji Zheng, Yupei Zhao, Weiyun Chen, Yuguang Huang
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. Guidelines for perioperative care after PD were published in 2013, but these recommendations could even change in one year. 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...
October 25, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29081065/minimally-invasive-surgery-and-enhanced-recovery-after-surgery-the-ideal-combination
#7
REVIEW
Basile Pache, Martin Hübner, Jonas Jurt, Nicolas Demartines, Fabian Grass
Enhanced recovery after surgery (ERAS) and minimally invasive surgery are both in the limelight due to their potential positive effects on surgical outcome. Large randomized trials and meta-analyses validated the use of both, laparoscopy and ERAS protocol, as individual measures. A synergistic effect of both entities might contribute to even better outcomes. This review hence assessed the literature upon up-to-date studies combining both methods.
October 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29080948/enhanced-recovery-after-surgery-for-radical-cystectomy-with-ileal-urinary-diversion-a-multi-institutional-randomized-controlled-trial-from-the-chinese-bladder-cancer-consortium
#8
Tianxin Lin, Kaiwen Li, Hao Liu, Xueyi Xue, Ning Xu, Yong Wei, Zhiwen Chen, Xiaozhou Zhou, Lin Qi, Wei He, Shiyu Tong, Fengshuo Jin, Xudong Liu, Qiang Wei, Ping Han, Xin Gou, Weiyang He, Xu Zhang, Guoqiang Yang, Zhoujun Shen, Tianyuan Xu, Xin Xie, Wei Xue, Ming Cao, Jin Yang, Jianyun Hu, Fubao Chen, Peijun Li, Guangyong Li, Tong Xu, Ye Tian, Wenying Wang, Dongkui Song, Lei Shi, Xiaoming Yang, Yang Yang, Benkang Shi, Yaofeng Zhu, Xigao Liu, Jinchun Xing, Zhun Wu, Kaiyan Zhang, Wei Li, Chaozhao Liang, Cheng Yang, Wei Li, Jinchun Qi, Chuanliang Xu, Weidong Xu, Liqun Zhou, Lin Cai, En'ci Xu, Weizhong Cai, Minggao Weng, Yiming Su, Fangjian Zhou, Lijuan Jiang, Zhuowei Liu, Qiuhong Chen, Tiejun Pan, Bo Liu, Yu Zhou, Xin Gao, Jianguang Qiu, Jie Situ, Cheng Hu, Shan Chen, Yupeng Zheng, Jian Huang
PURPOSE: Enhanced recovery after surgery (ERAS) has played an important role in recovery management for radical cystectomy with ileal urinary diversion (RC-IUD). This study is to evaluate ERAS compared with the conventional recovery after surgery (CRAS) for RC-IUD. METHODS: From October 2014 and July 2016, bladder cancer patients scheduled for curative treatment from 25 centers of Chinese Bladder Cancer Consortium were randomly assigned to either ERAS or CRAS group...
October 28, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29079551/assessing-the-value-of-prehabilitation-in-patients-undergoing-colorectal-surgery-according-to-the-enhanced-recovery-after-surgery-eras-pathway-for-the-improvement-of-postoperative-outcomes-protocol-for-a-randomized-controlled-trial
#9
Cornelia Merki-Künzli, Marta Kerstan-Huber, Denise Switalla, David Gisi, Dimitri Aristotle Raptis, Nicola Greco, Giuseppe Mungo, Markus Wirz, Severin Gloor, Merima Misirlic, Stefan Breitenstein, Christoph Tschuor
BACKGROUND: A key element in the postoperative phase of the standardized Enhanced Recovery After Surgery (ERAS) treatment pathways is mobilization. Currently, there are no recommendations in the ERAS guidelines for preoperative physical activity. Patients undergoing major surgery are prone to functional decline due to the impairment of muscle, cardiorespiratory, and neurological function as a response to surgical stress. It has been shown that preoperative physical training reduces postoperative complications...
October 27, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29078881/enhanced-recovery-after-surgery-program-in-patients-from-tibet-plateau-undergoing-surgeries-for-hepatic-alveolar-echinococcosis
#10
Mengchang Yang, Wenjie Su, Xiaofan Deng, Jia Deng, Peng Li, Xiangkui Li
BACKGROUND: Hepatic alveolar echinococcosis (HAE) is a severe and common parasitic disease in Tibetan Plateau of China. The infected patients have to move to plain areas to receive treatments due to the poor medical conditions in plateau areas. Our aim was to investigate the application of Enhanced Recovery after Surgery (ERAS) program in perioperative management for HAE patients from Tibet Plateau and the notes for patients with landform changes. MATERIAL AND METHODS: A total of 89 HAE patients from Tibet Plateau (altitude: average of 4500 m) prior received adaptive treatments at the cooperative hospital (altitude: 1500-2000 m) and accepted surgery at plain regions (altitude: 200-400 m)...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29067634/best-practice-in-major-elective-rectal-pelvic-surgery-enhanced-recovery-after-surgery-eras
#11
REVIEW
Josefin Segelman, Jonas Nygren
Within traditional clinical care, the postoperative recovery after pelvic/rectal surgery has been slow with high morbidity and long hospital stay. The enhanced recovery after surgery program is a multimodal approach to perioperative care designed to accelerate recovery and safely reduce hospital stay. This review will briefly summarize optimal perioperative care, before, during and after surgery in this group of patients and issues related to implementation and audit.
October 24, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29064879/the-successful-implementation-of-a-modified-enhanced-recovery-after-surgery-eras-program-for-bariatric-surgery-in-a-south-african-teaching-hospital
#12
Emil Loots, Benn Sartorius, Imran M Paruk, Damian L Clarke
BACKGROUND: This study assessed the impact of strict adherence to perioperative pathways incorporating an enhanced recovery after surgery protocol on the outcomes of bariatric surgery at our center. METHODS: Prospective data were collected on 62 patients undergoing bariatric surgery between January 2011 and March 2016. Outcomes were compared between those who adhered to the perioperative pathway and those who did not. RESULTS: Fifty-three patients underwent laparoscopic sleeve gastrectomy, and 9 patients underwent Laparoscopic Roux-en-Y Gastric Bypass...
October 23, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29061212/-current-status-of-prevention-and-nursing-on-venous-thromboembolism-among-perioperative-patients-with-lung-cancer
#13
E Zheng, Yudong Tang, Mei Yang, Guowei Che, Jiani Zhang, Na Du, Nansheng Cheng, Xiuying Hu
BACKGROUND: The purpose of this study was to explore the status of prevention and nursing on venous thromboembolism (VTE) among perioperative patients with lung cancer in Chinese hospital. METHODS: A self-designed questionnaire was used to investigate 108 head nurses from tertiary hospitals during the first West China Forum on Chest Enhanced Recovery After Surgery (ERAS). RESULTS: (1) Current status of assessment tools and prevention guidelines: 97...
October 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29058236/postoperative-care-and-functional-recovery-after-laparoscopic-sleeve-gastrectomy-vs-laparoscopic-roux-en-y-gastric-bypass-among-patients-under-eras-protocol
#14
Piotr Major, Tomasz Stefura, Piotr Małczak, Michał Wysocki, Jan Witowski, Jan Kulawik, Mateusz Wierdak, Magdalena Pisarska, Michał Pędziwiatr, Andrzej Budzyński
BACKGROUND: The most commonly performed bariatric procedures are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). There are major differences between LSG and LRYGB during postoperative period. Optimization of the postoperative care may be achieved by using enhanced recovery after surgery (ERAS) protocol, which allows earlier functional recovery. PURPOSE: The aim was to assess differences in the course of postoperative care conducted in accordance with ERAS protocol among patients after LSG and LRYGB...
October 23, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29049123/impact-of-enhanced-recovery-after-surgery-and-opioid-free-anesthesia-on-opioid-prescriptions-at-discharge-from-the-hospital-a-historical-prospective-study
#15
Delara Brandal, Michelle S Keller, Carol Lee, Tristan Grogan, Yohei Fujimoto, Yann Gricourt, Takashige Yamada, Siamak Rahman, Ira Hofer, Kevork Kazanjian, Jonathan Sack, Aman Mahajan, Anne Lin, Maxime Cannesson
BACKGROUND: The United States is in the midst of an opioid epidemic, and opioid use disorder often begins with a prescription for acute pain. The perioperative period represents an important opportunity to prevent chronic opioid use, and recently there has been a paradigm shift toward implementation of enhanced recovery after surgery (ERAS) protocols that promote opioid-free and multimodal analgesia. The objective of this study was to assess the impact of an ERAS intervention for colorectal surgery on discharge opioid prescribing practices...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29032237/hospital-charges-and-length-of-stay-following-radical-cystectomy-in-the-eras-era
#16
Alice Semerjian, Niv Milbar, Max Kates, Michael A Gorin, Hiten D Patel, Heather J Chalfin, Steven M Frank, Christopher L Wu, William W Yang, Deb Hobson, Lindsay Robertson, Elizabeth Wick, Mark P Schoenberg, Phillip M Pierorazio, Michael H Johnson, C J Stimson, Trinity J Bivalacqua
OBJECTIVE: To report our center's experience with Enhanced Recovery after Surgery (ERAS) pathway for radical cystectomy (RC), specifically evaluating complications, LOS, 30- and 90-day readmissions, and hospital charges. Pathways of this type have been shown to decrease length of stay (LOS) and post-operative ileus. However, concerns persist that ERAS is costly and increases readmissions. To date, limited studies have evaluated these concerns. MATERIALS AND METHODS: Our ERAS protocol was implemented for RC in December 2015...
October 12, 2017: Urology
https://www.readbyqxmd.com/read/29023334/application-of-enhanced-recovery-after-surgery-in-single-incision-laparoscopic-distal-gastrectomy
#17
Junfeng Zhou, Qingliang He, Jiaxing Wang, Qicai Liu, Mi Wang
BACKGROUND: Recently, enhanced recovery after surgery (ERAS) was widely used in the perioperative management of gastric cancer. The study aimed to evaluate the safety and effectiveness of ERAS in single-incision laparoscopic distal gastrectomy (SIDG). MATERIALS AND METHODS: A total of 90 patients who received laparoscopic gastric cancer resection were divided into 3 groups: group A (n=30), underwent traditional multiport laparoscopic distal gastrectomy with conventional perioperative management; group B (n=30) underwent traditional multiport laparoscopic distal gastrectomy with ERAS concept; and group C (n=30), underwent SIDG with ERAS concept...
October 11, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29019886/a-hospital-to-home-evaluation-of-an-enhanced-recovery-protocol-for-elective-pancreaticoduodenectomy-in-china-a-cohort-study
#18
RANDOMIZED CONTROLLED TRIAL
Wei Su, Fangyan Lu, Xiaoyu Zhang, Guogang Li, Wei Chen, Tao Ma, Shunliang Gao, Jianying Lou, Xueli Bai, Tingbo Liang
Enhanced recovery after surgery (ERAS) programs have been shown to decrease postoperative complications and hospital stay in pancreaticoduodenectomy. However, no studies concerned recovery after discharge except readmission. This study evaluated an ERAS program for pancreaticoduodenectomy from hospital to home.A prospective ERAS cohort undergoing elective pancreaticoduodenectomy was compared with a retrospective control group in terms of postoperative complications and hospital stay, and home recovery after discharge...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29017725/appropriateness-of-a-pediatric-specific-enhanced-recovery-protocol-using-a-modified-delphi-process-and-multidisciplinary-expert-panel
#19
Heather L Short, Natalie Taylor, Kaitlin Piper, Mehul V Raval
PURPOSE: Despite Enhanced Recovery After Surgery (ERAS) protocols demonstrating improved outcomes in a wide variety of adult surgical populations, these protocols are infrequently and inconsistently being used in pediatric surgery. Our purpose was to develop a pediatric-specific ERAS protocol for use in adolescents undergoing elective intestinal procedures. METHODS: A modified Delphi process including extensive literature review, iterative rounds of surveys, and expert panel discussions was used to establish ERAS elements that would be appropriate for children...
September 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28994339/intranasal-drug-delivery-devices-and-interventions-associated-with-post-operative-endoscopic-sinus-surgery
#20
Lari K Dkhar, Jim Bartley, David White, Ali Seyfoddin
This review article highlights the importance and advantages of the drug delivery systems applied via the nasal route after endoscopic sinus surgery (ESS) for patients suffering from chronic rhinosinusitis. After ESS, patients often require ongoing topical and systemic medication. To reduce the incidence of immediate and delayed post-surgical complications, a variety of temporary postoperative nasal interventions are currently used. However, newly developed intranasal drug delivery devices can enhance tissue recovery after endoscopic sinus surgery by releasing therapeutic drugs locally, while providing structural support to reduce tissue adhesion and scaring...
October 10, 2017: Pharmaceutical Development and Technology
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