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Enhanced Recovery After Surgery ERAS

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https://www.readbyqxmd.com/read/28222423/introduction-of-an-enhanced-recovery-after-surgery-protocol-for-robot-assisted-laparoscopic-radical-prostatectomy
#1
Motohiko Sugi, Tadashi Matsuda, Takashi Yoshida, Hisanori Taniguchi, Takao Mishima, Masaaki Yanishi, Yoshihiro Komai, Kaneki Yasuda, Hidefumi Kinoshita, Kenji Yoshida, Masato Watanabe
INTRODUCTION: No studies have shown whether the enhanced recovery after surgery (ERAS) protocol is superior to the conventional protocol after robot-assisted laparoscopic radical prostatectomy (RALP). We compared intestinal function and perioperative parameters of patients with prostate cancer after the ERAS and conventional protocols to determine the superior protocol for recovery of intestinal function. MATERIAL AND METHODS: A retrospective analysis of 198 consecutive patients who underwent RALP between August 2013 and June 2015 was conducted...
February 17, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#2
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
February 14, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28209144/modified-enhanced-recovery-after-surgery-eras-protocols-for-patients-with-obstructive-colorectal-cancer
#3
Dai Shida, Kyoko Tagawa, Kentaro Inada, Keiichi Nasu, Yasuji Seyama, Tsuyoshi Maeshiro, Sachio Miyamoto, Satoru Inoue, Nobutaka Umekita
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols are now well-known to be useful for elective colorectal surgery, as they result in shorter hospital stays without adversely affecting morbidity. However, the efficacy and safety of ERAS protocols for patients with obstructive colorectal cancer have yet to be clarified. METHODS: We evaluated 122 consecutive resections for obstructive colorectal cancer performed between July 2008 and November 2012 at Tokyo Metropolitan Bokutoh Hospital...
February 16, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28149935/readmission-rate-and-causes-at-90-day-after-radical-cystectomy-in-patients-on-early-recovery-after-surgery-protocol
#4
Emanuela Altobelli, Maurizio Buscarini, Harcharan S Gill, Eila C Skinner
Background: Radical cystectomy (RC) is associated with high risk of early and late perioperative complications, and readmissions. The Enhanced Recovery After Surgery (ERAS) protocol has been applied to RC showing decreased hospital stay without increased morbidity. Objective: To evaluate the specific causes of hospital readmissions in RC patients treated before and after adoption of an ERAS protocol at our institution. Methods: We retrospectively evaluated the outcome of 207 RC patients on ERAS protocol at the Stanford University Hospital from January 2012 to December 2014...
January 27, 2017: Bladder Cancer
https://www.readbyqxmd.com/read/28143397/retrospective-case-control-non-inferiority-analysis-of-intravenous-lidocaine-in-a-colorectal-surgery-enhanced-recovery-program
#5
Bhiken I Naik, Siny Tsang, Anne Knisely, Sandeep Yerra, Marcel E Durieux
BACKGROUND: Enhanced recovery after surgery (ERAS) programs typically utilizes multi-modal analgesia to reduce perioperative opioid consumption. Systemic lidocaine is used in several of these ERAS algorithms and has been shown to reduce opioid use after colorectal surgery. However it is unclear how much the other components of an ERAS protocol contribute to the final outcome. Using a noninferiority analysis we sought to assess the role of perioperative lidocaine in an ERAS program for colorectal surgery, using pain and opioid consumption as outcomes...
January 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28138958/randomized-clinical-trial-of-open-versus-laparoscopic-left-lateral-hepatic-sectionectomy-within-an-enhanced-recovery-after-surgery-programme-orange-ii-study
#6
E M Wong-Lun-Hing, R M van Dam, G J P van Breukelen, P J Tanis, F Ratti, R van Hillegersberg, G D Slooter, J H W de Wilt, M S L Liem, M T de Boer, J M Klaase, U P Neumann, L A Aldrighetti, C H C Dejong
BACKGROUND: Laparoscopic left lateral sectionectomy (LLLS) has been associated with shorter hospital stay and reduced overall morbidity compared with open left lateral sectionectomy (OLLS). Strong evidence has not, however, been provided. METHODS: In this multicentre double-blind RCT, patients (aged 18-80 years with a BMI of 18-35 kg/m(2) and ASA fitness grade of III or below) requiring left lateral sectionectomy (LLS) were assigned randomly to OLLS or LLLS within an enhanced recovery after surgery (ERAS) programme...
January 31, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28132917/reducing-postoperative-complications-and-improving-clinical-outcome-enhanced-recovery-after-surgery-in-pancreaticoduodenectomy-a-retrospective-cohort-study
#7
Juntao Dai, Yongjian Jiang, Deliang Fu
BACKGROUND: An enhanced recovery after surgery (ERAS) programme aims to reduce the stress response to surgery and thereby accelerate recovery. The experience of implementing the ERAS programmes in pancreatoduodenectomy (PD) is relatively limited. The aim of this study was to evaluate the feasibility, safety and clinical outcomes of the ERAS programme after PD at a high-volume Chinese university referral centre. METHODS: Between September 2014 and July 2016, a retrospective analysis of 166 consecutive patients who underwent PD at a tertiary referral care center was carried out...
January 26, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28100941/outcomes-of-laparoscopy-combined-with-enhanced-recovery-pathway-for-reversal-of-hartmann-s-procedure
#8
Liang Zhang, Yong Zhong, Hao Lin, Lv Xiao-Peng
The objective of this study is to discuss the security and feasibility of the laparoscopic reversal of Hartmann's procedure (LRHP) on the concept of enhanced recovery after surgery (ERAS). The clinical data of 42 patients who underwent laparoscopic reversal of Hartmann's procedure was retrospectively analyzed, and the operative time, blood loss, intraoperative and postoperative complications, conversion to open surgery, postoperative hospital stay, and so on were observed. Twenty-nine patients (69.00 % of the study pool) received complete postoperative recovery courses as prescribed by enhanced recovery program (ERP)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28097305/enhanced-recovery-after-surgery-a-review
#9
Olle Ljungqvist, Michael Scott, Kenneth C Fearon
Importance: Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations: Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care for the surgical patient...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28093901/does-hospital-readmission-following-colorectal-cancer-resection-and-enhanced-recovery-after-surgery-impact-on-long-term-survival
#10
Nathan J Curtis, Emma Noble, Emad Salib, Rob Hipkiss, Emily Meachim, Richard Dalton, Andrew Allison, Jonathan Ockrim, Nader K Francis
BACKGROUND: Hospital readmission is undesirable for patients and care providers as this can impact short-term recovery and carries financial consequences. It is unknown if readmission has long term implications. AIM: To investigate the impact of thirty day readmission on long term overall survival following colorectal cancer resection within enhanced recovery after surgery (ERAS) care and explore the reasons, severity and details of readmission episodes. METHODS: A dedicated, prospectively populated database was reviewed...
January 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#11
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
March 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28062937/protocol-for-enhanced-recovery-after-surgery-improves-short-term-outcomes-for-patients-with-gastric-cancer-a-randomized-clinical-trial
#12
Ryo Tanaka, Sang-Woong Lee, Masaru Kawai, Keitaro Tashiro, Satoshi Kawashima, Syuji Kagota, Kotaro Honda, Kazuhisa Uchiyama
BACKGROUND: The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear. METHODS: This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity...
January 6, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28054356/impact-of-a-peri-operative-quality-improvement-programme-on-postoperative-pulmonary-complications
#13
J A Moore, D H Conway, N Thomas, D Cummings, D Atkinson
Postoperative pulmonary complications are common, with a reported incidence of 2-40%, and are associated with adverse outcomes that include death, longer hospital stay and reduced long-term survival. Enhanced recovery is now a standard of care for patients undergoing elective major surgery. Despite the high prevalence of pulmonary complications in this population, few elements of enhanced recovery specifically address reducing these complications. In 2013, a prevalence audit confirmed a postoperative pulmonary complication rate of 16/83 (19...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#14
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28009729/impact-of-enhanced-recovery-after-surgery-and-fast-track-surgery-pathways-on-healthcare-associated-infections-results-from-a-systematic-review-and-meta-analysis
#15
Michael C Grant, Dongjie Yang, Christopher L Wu, Martin A Makary, Elizabeth C Wick
OBJECTIVE: The aim of this study was to establish if enhanced recovery after surgery (ERAS) and fast track surgery (FTS) protocols are associated with reduction in healthcare-associated infection (HAIs). BACKGROUND: Evidence suggests that prevention strategies for HAIs should be multifaceted and transdisciplinary. ERAS and FTS protocols are collaborative approaches to perioperative care which reduce length of stay but may also be an effective strategy for reducing HAIs...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28009223/development-of-an-enhanced-recovery-after-surgery-eras-approach-for-lumbar-spinal-fusion
#16
Michael Y Wang, Peng-Yuan Chang, Jay Grossman
OBJECTIVE Over the past decade, Enhancing Recovery After Surgery (ERAS) programs have been implemented throughout the world across multiple surgical disciplines. However, to date no spinal surgery equivalent has been described. In this report the authors review the development and implementation of a "fast track" surgical approach for lumbar fusion. METHODS The first 42 consecutive cases in which patients were treated with the new surgical procedure were reviewed. A combination of endoscopic decompression, expandable cage deployment, and percutaneous screw placement were performed with liposomal bupivacaine anesthesia to allow the surgery to be performed without general endotracheal anesthesia...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28002175/executive-summary-enhanced-recovery-after-surgery-best-practice-guideline-for-care-of-patients-with-a-fecal-diversion
#17
Debbie Miller, Emily Pearsall, Debra Johnston, Monica Frecea, Marg McKenzie
Enhanced Recovery After Surgery (ERAS) is a multimodal program developed to decrease postoperative complications, improve patient safety and satisfaction, and promote early discharge. In the province of Ontario, Canada, a standardized approach to the care of adult patients undergoing elective colorectal surgery (including benign and malignant diseases) was adopted by 15 hospitals in March 2013. All colorectal surgery patients with or without an ostomy were included in the ERAS program targeting a length of stay of 3 days for colon surgery and 4 days for rectal surgery...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/27988869/comparative-pharmacology-and-guide-to-the-use-of-the-serotonin-5-ht3-receptor-antagonists-for-postoperative-nausea-and-vomiting
#18
Anthony L Kovac
Since the introduction of the serotonin 5-hydroxy tryptamine 3 (5-HT3) receptor antagonists in the early 1990s, the incidence of postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) has decreased, yet continues to be a problem for the surgical patient. The clinical application of the 5-HT3 receptor antagonists has helped define the approach and role of these antiemetics in the prevention and treatment of PONV and PDNV. Pharmacological and clinical differences exist among these medications resulting in corresponding differences in effectiveness, safety, optimal dosage, time of administration, and use as combination and rescue antiemetic therapy...
December 2016: Drugs
https://www.readbyqxmd.com/read/27986184/the-canadian-gynaecologic-oncology-perioperative-management-survey-baseline-practice-prior-to-implementation-of-enhanced-recovery-after-surgery-eras-society-guidelines
#19
Alon D Altman, Gregg S Nelson
OBJECTIVE: To survey the current practice of Society of Gynecologic Oncology of Canada (GOC) members about preoperative, intraoperative, and postoperative phases of care. The survey was carried out prior to publication of the Enhanced Recovery After Surgery (ERAS) Society gynaecologic/oncology guidelines. METHODS: A survey was developed by the GOC and distributed to all surgical members between September and December 2015. RESULTS: The survey was completed by 77 of 92 practising gynaecologic oncologists (84%), representing 19 centres in 16 cities across Canada...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27979491/postoperative-urinary-retention-in-colorectal-surgery-within-an-enhanced-recovery-pathway
#20
Fabian Grass, Juliette Slieker, Pierre Frauche, Josep Solà, Catherine Blanc, Nicolas Demartines, Martin Hübner
BACKGROUND: Enhanced recovery after surgery (ERAS) guidelines for colorectal surgery suggest routine transurethral bladder drainage with early removal to prevent urinary tract infection (UTI). The aim of this study was to identify risk factors for urinary retention (UR). METHODS: This retrospective analysis included all colorectal patients since ERAS implementation in May 2011-November 2014. From the prospective ERAS database, over 100 items related to demographics, surgery, compliance, and outcome were analyzed...
January 2017: Journal of Surgical Research
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