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Enhanced Recovery After Surgery ERAS

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https://www.readbyqxmd.com/read/29784507/in-hospital-length-of-stay-after-major-surgical-oncological-procedures
#1
Sebastiano Nazzani, Felix Preisser, Elio Mazzone, Zhe Tian, Francesco A Mistretta, Shahrokh F Shariat, Fred Saad, Markus Graefen, Derya Tilki, Emanuele Montanari, Stefano Luzzago, Alberto Briganti, Luca Carmignani, Pierre I Karakiewicz
BACKGROUND AND OBJECTIVES: Enhanced recovery after surgery protocols (ERAS) have been developed and implemented as of 2001. However, no previous analyses targeted length of stay (LOS) changes over time after major surgical oncological procedures (MSOPs). METHODS: Between 2003 and 2013, we retrospectively identified patients, who underwent prostatectomy, colectomy, cystectomy, mastectomy, gastrectomy, hysterectomy, nephrectomy, oophorectomy, lung resection or pancreatectomy within the Nationwide Inpatient Sample...
May 9, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29782405/the-impact-of-anesthesia-influenced-process-measure-compliance-on-length-of-stay-results-from-an-enhanced-recovery-after-surgery-for-colorectal-surgery-cohort
#2
Michael C Grant, Claro M Pio Roda, Joseph K Canner, Philip Sommer, Daniel Galante, Deborah Hobson, Susan Gearhart, Christopher L Wu, Elizabeth Wick
BACKGROUND: Process measure compliance has been associated with improved outcomes in enhanced recovery after surgery (ERAS) programs. Herein, we sought to assess the impact of compliance with measures directly influenced by anesthesiology in an ERAS for colorectal surgery cohort. METHODS: From January 2013 to April 2015, data from 1140 consecutive patients were collected for all patients before (pre-ERAS) and after (ERAS) implementation of an ERAS program. Compliance with 9 specific process measures directly influenced by the anesthesiologist or acute pain service was analyzed to determine the impact on hospital length of stay (LOS)...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29779809/identification-of-core-items-in-the-enhanced-recovery-pathway
#3
Marco Braga, Marco Scatizzi, Felice Borghi, Giancarlo Missana, Danilo Radrizzani, Marco Gemma
BACKGROUND & AIMS: The Enhanced Recovery After Surgery (ERAS) pathway represents an optimal approach in patients undergoing colorectal surgery but complexity in implementing its items could limit its application. The aim of this study is to identify possible core items within an ERAS pathway following elective colorectal resection. METHODS: This is a retrospective review of data prospectively collected between January 2014 and September 2015 by 14 Italian Hospitals in an electronic registry dedicated to an ERAS protocol...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29777454/improved-outcomes-in-394-pancreatic-cancer-resections-the-impact-of-enhanced-recovery-pathway
#4
Vandana Agarwal, Martin Jose Thomas, Riddhi Joshi, Vikram Chaudhari, Manish Bhandare, Abhishek Mitra, Ashwin deSouza, Reshma Ambulkar, Shailesh V Shrikhande
BACKGROUND: Enhanced recovery (ER) pathway reduces morbidity and accelerates recovery. It is associated with reduced postoperative stay, morbidity, and costs. Feasibility and safety of ER programme has not been studied in developing countries. The objectives were to assess compliance with Enhanced Recovery After Surgery (ERAS) elements and to assess outcomes in pancreatic surgery. METHODS: Prospective study conducted from February 2014 to December 2016, following elective pancreatic cancer surgery...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29774939/-feasibility-and-preliminary-technical-experience-of-single-incision-plus-one-port-laparoscopic-total-gastrectomy-combined-with-%C3%AF-shaped-esophagojejunal-anastomosis-in-surgical-treatment-of-gastric-cancer
#5
Guangsheng Du, Enlai Jiang, Yuan Qiu, Wensheng Wang, Shuai Wang, Yunbo Li, Ke Peng, Xiang Li, Hua Yang, Weidong Xiao
OBJECTIVE: To explore the feasibility, safety, and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis (SILT-π) in the surgical treatment of gastric cancer. METHODS: Clinical data of 5 gastric cancer patients undergoing SILT-π operation at the Department of General Surgery, The Second Affiliated Hospital of the Army Medical University from August to October 2017 were retrospectively analyzed...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29761863/surgical-treatment-of-esophageal-cancer-in-the-era-of-multimodality-management
#6
REVIEW
Alicia S Borggreve, B Feike Kingma, Serg A Domrachev, Mikhail A Koshkin, Jelle P Ruurda, Richard van Hillegersberg, Flavio R Takeda, Lucas Goense
Over the last decades, the treatment of resectable esophageal cancer has evolved into a multidisciplinary process in which all players are essential for treatment to be successful. Medical oncologists and radiation oncologists have been increasingly involved since the implementation of neoadjuvant therapy, which has been shown to improve survival. Although esophagectomy is still considered the cornerstone of curative treatment for locally advanced esophageal cancer, it remains associated with considerable postoperative morbidity, despite promising results of minimally invasive techniques...
May 15, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29754619/enhanced-recovery-after-surgery-protocols-rationale-and-components
#7
REVIEW
Kyle L Kleppe, Jacob A Greenberg
Enhanced recovery after surgery (ERAS) protocols are spreading throughout various fields in surgery. ERAS protocols involve the implementation of evidence-based elements of care that are applied throughout the entire perioperative period to facilitate optimal recovery for the patient. ERAS protocols have been associated with improvements in quality of care, patient-reported and operative outcomes, and patient safety as well as reductions in cost. Thus, ERAS protocols have led to an overall improvement in health care value for the patient and the health care system...
June 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29754385/four-year-evolution-of-a-thrombophylaxis-protocol-in-an-enhanced-recovery-after-surgery-eras-program-recent-results-in-485-patients
#8
Marie-Cécile Blanchet, Vincent Frering, Benoît Gignoux, Yann Matussière, Philippe Oudar, Romain Noël, Alban Mirabaud
"Enhanced recovery after surgery" (ERAS) protocols may reduce morbidity, length of hospital stay (LOS), and costs. During the 4-year evolution of a bariatric ERAS protocol, we found that administration of thrombophylaxis selectively to high-risk morbidly obese patients (assessed postoperatively by Caprini score ≥ 3) undergoing omega loop gastric bypass ("mini" gastric bypass) or sleeve gastrectomy resulted in safe outcomes. Both procedures proved equally effective with this protocol...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29752858/enhanced-recovery-after-surgery-in-children-promising-evidence-based-multidisciplinary-care
#9
Kyle O Rove, John C Edney, Megan A Brockel
Enhanced recovery after surgery (ERAS) is a multimodal approach to the care of the surgical patient focused on reducing the stress response and associated physiologic changes that accompany surgery. Over the past 20 years, ERAS programs have been found to result in reduced LOS and complications in adult patients. Despite abundant adult literature describing implementation and outcomes of enhanced recovery programs, pediatric data in this area is sparse. This educational review describes the history and elements of ERAS protocols, reviews the available evidence in adult and pediatric populations, compares and contrasts ERAS with the PSH, and offers strategies for implementation and ideas for future directions of ERAS in children...
May 12, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29750324/enhanced-recovery-after-surgery-programs-for-laparoscopic-abdominal-surgery-a-systematic-review-and-meta-analysis
#10
REVIEW
Zhengyan Li, Qingchuan Zhao, Bin Bai, Gang Ji, Yezhou Liu
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols or laparoscopic technique has been applied in various surgical procedures. However, the clinical efficacy of combination of the two methods still remains unclear. Thus, our aim was to assess the role of ERAS protocols in laparoscopic abdominal surgery. METHODS: We performed a systematic literature search in various databases from January 1990 to October 2017. The results were analyzed according to predefined criteria...
May 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29750321/improved-outcomes-of-enhanced-recovery-after-surgery-eras-protocol-for-radical-cystectomy-with-addition-of-a-multidisciplinary-care-process-in-a-us-comprehensive-cancer-care-center
#11
Sephalie Y Patel, Rosemarie E Garcia Getting, Brandon Alford, Karim Hussein, Braydon J Schaible, David Boulware, Jae K Lee, Scott M Gilbert, Julio M Powsang, Wade J Sexton, Philippe E Spiess, Michael A Poch
INTRODUCTION: Although enhanced recovery after surgery (ERAS) components include both anesthesia and surgical care processes, it is unclear whether a multidisciplinary approach to implementing ERAS care processes improves clinical outcomes. The addition of multidisciplinary care with anesthesiology-related components to an existing ERAS protocol for radical cystectomy at a US comprehensive cancer center provided an opportunity to compare short- and long-term outcomes. METHODS: We retrospectively compared the outcomes of 116 consecutive patients who underwent cystectomy after implementation of a multidisciplinary ERAS protocol with those of a historical control group of 143 consecutive patients who had been treated with a surgical ERAS protocol...
May 10, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29747091/effect-of-herbal-medicine-daikenchuto-on-oral-and-enteral-caloric-intake-after-liver-transplantation-a-multicenter-randomized-controlled-trial
#12
Toshimi Kaido, Masahiro Shinoda, Yukihiro Inomata, Takahito Yagi, Nobuhisa Akamatsu, Yasutsugu Takada, Hideki Ohdan, Tsuyoshi Shimamura, Yasuhiro Ogura, Susumu Eguchi, Hidetoshi Eguchi, Satoshi Ogata, Tomoharu Yoshizumi, Toshihiko Ikegami, Michio Yamamoto, Satoshi Morita, Shinji Uemoto
OBJECTIVE: Postoperative early oral or enteral intake is a crucial element of the Enhanced Recovery After Surgery (ERAS) protocol. However, normal food intake or enteral feeding cannot be started early in the presence of coexisting bowel dysfunction in patients undergoing liver transplantation (LT). The aim of this multicenter, randomized, double-blinded, placebo-controlled trial was to determine the enhancement effects of the Japanese herbal medicine Daikenchuto (DKT) on oral/enteral caloric intake in patients undergoing LT...
March 20, 2018: Nutrition
https://www.readbyqxmd.com/read/29746417/implementing-enhanced-recovery-after-surgery-eras-program-on-a-specialty-nursing-unit
#13
Kendra Tezber, Cesar Aviles, Misty Eller, Allyson Cochran, David Iannitti, Dionisios Vrochides, Garth McClune
Implementing Enhanced Recovery After Surgery (ERAS) guidelines is an effective method to standardize patient care, improve patient outcomes, and develop quality improvement projects. Completing the required ERAS Implementation Program provided by the International ERAS Society enabled the hepatopancreaticobiliary surgery team at Carolinas HealthCare System to successfully implement evidence-based practice changes for pancreaticoduodenectomy patients on an acuity-adjustable unit resulting in improved care and cost reduction...
May 10, 2018: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29744679/current-status-of-enhanced-recovery-after-surgery-eras-protocol-in-gastrointestinal-surgery
#14
REVIEW
Michał Pędziwiatr, Judene Mavrikis, Jan Witowski, Alexandros Adamos, Piotr Major, Michał Nowakowski, Andrzej Budzyński
Enhanced Recovery After Surgery (ERAS) is an evidence-based paradigm shift in perioperative care, proven to lower both recovery time and postoperative complication rates. The role of ERAS in several surgical disciplines was reviewed. In colorectal surgery, ERAS protocol is currently well established as the best care. In gastric surgery, 2014 saw an establishment of ERAS protocol for gastrectomies with resulting meta-analysis showing ERAS effectiveness. ERAS has also been shown to be beneficial in liver surgery with many centers starting implementation...
May 9, 2018: Medical Oncology
https://www.readbyqxmd.com/read/29733252/preliminary-report-on-introduction-of-enhanced-recovery-after-surgery-protocol-for-laparoscopic-rectal-resection-a-single-center-experience
#15
Davide Cintorino, Calogero Ricotta, Pasquale Bonsignore, Fabrizio Di Francesco, Sergio Li Petri, Duilio Pagano, Alessandro Tropea, Giuliana Checchini, Fabio Tuzzolino, Salvatore Gruttadauria
INTRODUCTION: Laparoscopic rectal surgery seems to improve postoperative recovery of patients who undergo surgery for rectal cancer. The aim of this study was to evaluate preliminary results of implementation of enhanced recovery after surgery (ERAS) protocol for laparoscopic rectal resection (LRR) for cancer at our institute. MATERIALS AND METHODS: We conducted a retrospective analysis of prospectively collected data. Patients who underwent LRR for cancer at our institute after introduction of enhanced recovery protocol were compared with a control group of patients who previously underwent surgery with traditional protocol...
May 7, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29732387/transversus-abdominis-plane-blockade-as-part-of-a-multimodal-postoperative-analgesia-plan-in-patients-undergoing-radical-cystectomy
#16
Richard S Matulewicz, Mehul Patel, Brian J Jordan, Jacqueline Morano, Brendan Frainey, Yasin Bhanji, Mahreen Bux, Antoun Nader, Shilajit D Kundu, Joshua J Meeks
Background: Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol. Objective: To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC. Methods: A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted...
April 26, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29730070/exercise-prehabilitation-in-elective-intra-cavity-surgery-a-role-within-the-eras-pathway-a-narrative-review
#17
REVIEW
Samuel T Orange, Matthew J Northgraves, Phil Marshall, Leigh A Madden, Rebecca V Vince
The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. PREHAB refers to the systematic process of improving functional capacity of the patient to withstand the upcoming physiological stress of surgery...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#18
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29721734/short-term-outcomes-and-benefits-of-eras-program-in-elderly-patients-undergoing-colorectal-surgery-a-case-matched-study-compared-to-conventional-care
#19
Patricia Tejedor, Carlos Pastor, Santiago Gonzalez-Ayora, Mario Ortega-Lopez, Hector Guadalajara, Damian Garcia-Olmo
PURPOSE: The aim of the study was to evaluate the benefits of implementing Enhanced Recovery After Surgery (ERAS) protocols in elderly patients undergoing elective colorectal surgery. METHODS: A retrospective non-randomized cohort study was conducted from September 2012 to December 2016. We included patients ≥ 70 years undergoing elective colorectal surgery. Outcome measures, compliance with interventions, and postoperative complications of patients treated under ERAS were case-matched (based on gender, age, type of surgery, and the presence/absence of a temporal stoma) to a retrospective group of patients ≥ 70 years treated under conventional care...
May 3, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29721637/application-of-an-enhanced-recovery-pathway-for-ileostomy-closure-a-case-control-trial-with-surprising-results
#20
J Slieker, M Hübner, V Addor, C Duvoisin, N Demartines, D Hahnloser
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols have been widely validated in colorectal surgery; however, few data exist on loop ileostomy closure. The aim of this study was to compare clinical outcomes before and after introduction of ERAS for loop ileostomy closure. METHODS: Data on outcomes after loop ileostomy closure were retrospectively collected before ERAS was applied at our department (control group). These results were compared to results of patients undergoing loop ileostomy closure within the original colorectal ERAS pathway (ERAS 1 group); after analysis of these results, adaptations were made to the ERAS pathway regarding the postoperative diet, and this second category of patients was analyzed (ERAS 2 group)...
May 3, 2018: Techniques in Coloproctology
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