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Enhanced Recovery After Surgery ERAS

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https://www.readbyqxmd.com/read/28922216/opioid-free-analgesia-in-the-era-of-enhanced-recovery-after-surgery-and-the-surgical-home-implications-for-postoperative-outcomes-and-population-health
#1
Nirav V Kamdar, Nir Hoftman, Siamak Rahman, Maxime Cannesson
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28916971/emergency-room-visits-and-readmissions-following-implementation-of-an-enhanced-recovery-after-surgery-ieras-program
#2
Trevor Wood, Mary-Anne Aarts, Allan Okrainec, Emily Pearsall, J Charles Victor, Marg McKenzie, Ori Rotstein, Robin S McLeod
BACKGROUND: Enhanced Recovery After Surgery (ERAS) guidelines have been widely promoted and supported largely due to several studies showing decreased post-operative complications and length of stay. The objective of this study was to review the emergency room (ER) visits and readmission rates and reasons for both in patients who were part of the Implementation of an Enhanced Recovery After Surgery (iERAS) program for colorectal surgery. METHODS: All patients having elective colorectal surgery at 15 academic hospitals were enrolled in the iERAS program...
September 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28913487/perioperative-surgical-home-meeting-tomorrow-s-challenges
#3
REVIEW
Teodora O Nicolescu
New healthcare models pose a variety of changes for anesthesiologists, ranging from the need to improve quality and to cost containment: as such, the concept of Perioperative Surgical Home (PSH) has been developed. Modelled after the UK's Enhanced Recovery After Surgery (ERAS), PSH takes a step further by coordinating care starting from the time a surgical decision is made for the patient to as many as 30 days postoperatively, taking a logical evidenced-based approach to judicious preoperative testing. Perioperative surgical home also relies heavily on engineering imported strategies such as the use of Lean Six Sigma methodologies, and involves active participation of all stakeholders...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28881829/compliance-with-the-enhanced-recovery-after-surgery-protocol-and-prognosis-after-colorectal-cancer-surgery-a-prospective-cohort-study
#4
Liang Li, Juying Jin, Su Min, Dan Liu, Ling Liu
We explored the effects of different levels of compliance with an enhanced recovery after surgery (ERAS) protocol on the short-term prognosis of patients who underwent colorectal cancer surgery. We conducted a single-center prospective cohort study in which 254 patients who received surgical treatment in a teaching tertiary care hospital were enrolled from March 2016 to November 2016. The patients were divided into four groups (I, II, III, and IV) based on individual compliance rates; the corresponding range of compliance rates was 0-60%, 60-70%, 70-80%, and 80-100%, and the number of patients in each group was 66, 63, 53, and 72, respectively...
August 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28870052/-clinical-efficacy-of-enhanced-recovery-after-surgery-in-atrial-caval-shunting-for-type-%C3%A2-budd-chiari-syndrome
#5
G J Tian, D Y Li, H B Yu, Y D Dong, Y N Peng, P Liu, Y K Wei, H Z Xue
Objective: To investigate the clinical efficacy of enhanced recovery after surgery(ERAS) in atrial caval shunting (ACS) for type Ⅱ Budd-Chiari syndrome(BCS). Methods: The clinical data of patients underwent ACS for type Ⅱ BCS in the Henan Province People's Hospital from January 2014 to June 2016 were prospectively analyzed.Randomized and single-blind, controlled study was performed among the patients, and all of them underwent ACS and were divided into control group (patients underwent traditional perioperative management) and ERAS group (patients underwent ERAS perioperative management) based on a random number table...
September 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28867465/effect-of-gum-chewing-on-ameliorating-ileus-following-colorectal-surgery-a-meta-analysis-of-18-randomized-controlled-trials
#6
REVIEW
Qing Liu, Honglei Jiang, Dong Xu, Junzhe Jin
BACKGROUND AND OBJECTIVE: Chewing gum, as an alternative to sham feeding, had been shown to hasten the recovery of gut function following abdominal surgery. However, conclusions remained contradictory. We sought to conduct an updated meta-analysis to evaluate the efficacy of gum chewing in alleviating ileus following colorectal surgery. METHODS: We searched PubMed, EMBASE, and Cochrane Library Databases through February 2017 to identify randomized controlled trials (RCTs) evaluating the efficacy of the additional use of chewing gum following colorectal surgery...
August 31, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28859687/healthcare-professionals-views-of-the-enhanced-recovery-after-surgery-programme-a-qualitative-investigation
#7
Georgia Herbert, Eileen Sutton, Sorrel Burden, Stephen Lewis, Steve Thomas, Andy Ness, Charlotte Atkinson
BACKGROUND: The Enhanced Recovery After Surgery (ERAS) programme is an approach to the perioperative care of patients which aims to improve outcomes and speed up recovery after surgery. Although the evidence base appears strong for this programme, the implementation of ERAS has been slow. This study aimed to gain an understanding of the facilitating factors and challenges of implementing the programme with a view to providing additional contextual information to aid implementation. The study had a particular focus on the nutritional elements as these have been highlighted as important...
August 31, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28855036/-enhanced-lung-recovery-after-surgery-is-it-a-necessary-for-precision-therapy
#8
REVIEW
Guowei Che, Lunxu Liu
The concept of enhanced recovery after surgery (ERAS) has already been accepted by almost all the clinicians and nurses, the practice of which is based on interdisciplinary cooperation. The reason is still unclear why the effect of ERAS varies a lot though the same ERAS scheme is used. The main cause may be the same ERAS scheme can not be suitable for different patients. In other words, does ERAS also need to conform to Precision Medicine Theory? This study is focused on the necessity and clinical efficacy of "Precision ERAS" performed in lung cancer patients...
August 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/28840005/outcomes-after-implementing-the-enhanced-recovery-after-surgery-protocol-for-patients-undergoing-tuberculous-empyema-operations
#9
Zhaohua Xia, Kun Qiao, Haijiang Wang, Xinzhong Ning, Jianxing He
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols provide recommendations for care in various surgical fields. However, there is scarce information on the application of these protocols in tuberculous empyema surgery. The purpose of this research is to evaluate the outcomes of ERAS recommendations for patients who received tuberculous empyema surgery. METHODS: A retrospective analysis was performed on patients who underwent tuberculous empyema surgery in our hospital from March 2011 to March 2016...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28829221/enhanced-recovery-after-surgery-in-laparoscopic-surgery
#10
Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28815075/the-feeding-route-after-esophagectomy-a-review-of-literature
#11
REVIEW
Gijs H Berkelmans, Frans van Workum, Teus J Weijs, Grard A Nieuwenhuijzen, Jelle P Ruurda, Ewout A Kouwenhoven, Marc J van Det, Camiel Rosman, Richard van Hillegersberg, Misha D Luyer
Enhanced recovery programs effectively optimize perioperative care and reduce postoperative morbidity. In esophagectomy, several components of the ERAS program are successfully introduced. However, timing and type of postoperative feeding remain a matter of debate. Adequate nutritional support is essential in patients undergoing an esophagectomy. These patients often present with weight loss and their eating pattern is strongly altered by the procedure and reconstruction. Total parenteral nutrition (TPN) is associated with severe septic complications and enteral nutrition (EN) does not increase major complications...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28808868/effect-of-multimodal-analgesia-on-opioid-use-after-open-ventral-hernia-repair
#12
Jeremy A Warren, Caroline Stoddard, Ahan L Hunter, Anthony J Horton, Carlyn Atwood, Joseph A Ewing, Steven Pusker, Vito A Cancellaro, Kevin B Walker, William S Cobb, Alfredo M Carbonell, Robert R Morgan
BACKGROUND: There is limited data on enhanced recovery after surgery (ERAS) protocols after ventral hernia repair (VHR). This study reports the impact of multimodal analgesia on opioid use after open VHR. METHODS: Retrospective review of open VHR treated during the initial 6 months after ERAS implementation. Protocol focused on opioid sparing using intraoperative ketamine and/or lidocaine infusion, selective epidural anesthesia, and postoperative ketamine infusion, ketorolac, and acetaminophen...
August 14, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28807482/postoperative-complications-after-head-and-neck-operations-that-require-free-tissue-transfer-prevalence-morbidity-and-cost
#13
J McMahon, T P B Handley, A Bobinskas, M Elsapagh, H S Anwar, P V Ricciardo, A McLaren, R Davis, N Syyed, C MacIver, C Wales, W S Hislop, E Thomson, S Thomson, K Fitzpatrick, A Rae, R Campbell
To understand and reduce the impact of postoperative complications, we studied 568 patients who had had operations over 72 months in our hospital. Multivariate analysis indicated that factors indicative of coexisting conditions (including activated systemic inflammation) and the complexity of the operation are primary determinants of postoperative complications. The enhanced recovery after surgery (ERAS) care pathway did not have an effect on their occurrence or severity. Systematic study of patients' toleration of major head and neck operations is required, as optimal perioperative care pathways remain elusive...
August 11, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28801130/prospective-implementation-of-enhanced-recovery-after-surgery-protocols-to-radical-cystectomy
#14
Karl H Pang, Ruth Groves, Suresh Venugopal, Aidan P Noon, James W F Catto
BACKGROUND: Multimodal enhanced recovery after surgery (ERAS) regimens have improved outcomes from colorectal surgery. OBJECTIVE: We report the application of ERAS to patients undergoing radical cystectomy (RC). DESIGN, SETTING, AND PARTICIPANTS: Prospective collection of outcomes from consecutive patients undergoing RC at a single institution. INTERVENTION: Twenty-six components including prehabilitation exercise, same day admission, carbohydrate fluid loading, targeted intraoperative fluid resuscitation, regional local anaesthesia, cessation of nasogastric tubes, omitting oral bowel preparation, avoiding drain use, early mobilisation, chewing gum use, and audit...
August 8, 2017: European Urology
https://www.readbyqxmd.com/read/28795911/the-development-of-enhanced-recovery-after-surgery-across-surgical-specialties
#15
James C Senturk, Gentian Kristo, Jason Gold, Ronald Bleday, Edward Whang
BACKGROUND: Enhanced recovery after surgery (ERAS(®)) principles have gained traction in variety of surgical disciplines. The promise of a reduced length of stay without compromising patient safety or increasing readmission rates has produced a body of literature examining the implementation of ERAS in the care of general, thoracic, urologic, and gynecologic surgery patients. METHODS: We performed a review of the literature pertaining to studies of ERAS implementation across colorectal surgery, general surgery, thoracic surgery, urology, and gynecology...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28795858/the-history-of-enhanced-recovery-after-surgery-and-the-eras-society
#16
Olle Ljungqvist, Tonia Young-Fadok, Nicolas Demartines
This short historical overview explains the development of enhanced recovery from a small group of surgeons in European academic centers to the establishment of ERAS(®)Society, a not-for-profit multiprofessional multidisciplinary medical-academic society, reaching all major continents and involving a wide range of surgical and anesthesia disciplines.
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28790296/-clinical-practice-of-enhanced-recovery-after-surgery-program-for-esophagectomy
#17
Masato Nishida, Yasuyuki Seto
Enhanced recover after surgery(ERAS) program is multimodal strategies to reduce the incidence of postoperative morbidity and mortality, and encourage early functional recovery from surgical insult. It consists of physical therapy to facilitate postoperative early mobilization, nutritional support, introduction of minimal invasive surgery, restrictive fluid therapy and early resumption of oral intake. Esophagectomy for esophageal cancer is a highly invasive procedure with high incidence of postoperative morbidity and mortality...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28767578/enhanced-recovery-after-surgery-program-reduces-length-of-hospital-stay-and-complications-in-liver-resection-a-prisma-compliant-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#18
REVIEW
Yiyang Zhao, Han Qin, Yang Wu, Bo Xiang
BACKGROUND: Many enhanced recovery after surgery (ERAS) guidelines have already been established in several kinds of surgeries. But due to concerns of the specific complications, it has not yet been considered the standard of care in liver surgery. OBJECTIVE: The aim of this review is to assess the effect of ERAS in patients undergoing liver surgery. METHODS: EMBASE, CNKI, PubMed, and the Cochrane Database were searched for randomized controlled trials (RCTs) comparing ERAS with conventional care in patients undergoing liver surgery...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28767125/eras-improving-outcome-in-the-cachectic-hpb-patient
#19
REVIEW
David P J van Dijk, Victor van Woerden, Hamit Cakir, Marcel den Dulk, Steven W M Olde Damink, Cornelis H C Dejong
The enhanced recovery after surgery (ERAS) program has reduced postoperative morbidity and duration of hospital stay but not mortality in patients undergoing hepatopancreatobiliary (HPB) surgery. Many HPB patients suffer from cancer cachexia, a syndrome of severe weight and muscle loss. This may affect outcomes of HPB surgery even within an ERAS program. A tailored ERAS approach may be essential in further improving outcome in this vulnerable patient category.
August 2, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28762024/risk-factors-for-prolonged-length-of-hospital-stay-and-readmissions-after-laparoscopic-sleeve-gastrectomy-and-laparoscopic-roux-en-y-gastric-bypass
#20
Piotr Major, Michał Wysocki, Grzegorz Torbicz, Natalia Gajewska, Alicja Dudek, Piotr Małczak, Michał Pędziwiatr, Magdalena Pisarska, Dorota Radkowiak, Andrzej Budzyński
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions. METHODS: The study was a prospective observation with a post-hoc analysis of bariatric patients in a tertiary referral university teaching hospital...
July 31, 2017: Obesity Surgery
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