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Enhanced Recovery After Surgery ERAS

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https://www.readbyqxmd.com/read/29327644/evaluation-of-supervised-multimodal-prehabilitation-programme-in-cancer-patients-undergoing-colorectal-resection-a-randomized-control-trial
#1
Guillaume Bousquet-Dion, Rashami Awasthi, Sarah-Ève Loiselle, Enrico M Minnella, Ramanakumar V Agnihotram, Andreas Bergdahl, Francesco Carli, Celena Scheede-Bergdahl
BACKGROUND: Prehabilitation has been previously shown to be more effective in enhancing postoperative functional capacity than rehabilitation alone. The purpose of this study was to determine whether a weekly supervised exercise session could provide further benefit to our current prehabilition program, when comparing to standard post-surgical rehabilitation. METHODS: A parallel-arm single-blind randomized control trial was conducted in patients scheduled for non-metastatic colorectal cancer resection...
January 12, 2018: Acta Oncologica
https://www.readbyqxmd.com/read/29325348/-multidisciplinary-team-building-in-enhanced-recovery-after-surgery
#2
W D Jia
There has been 10 years to explore the road in line with China's actual enhanced recovery after surgery(ERAS) since Academician Li Jieshou introduced the view of ERAS into China. ERAS has been widely carried out in the field of surgery, and gradually formed with Chinese characteristics of ERAS clinical pathway.The clinical implementation of ERAS relies on the effective integration of a series of perioperative methods, and any single technique or method can't completely reduce the perioperative physiological and psychological traumatic stress of the patient, so as to achieve the patient's rapid rehabilitation patient-centered multidisciplinary team(MDT)collaboration is an inevitable trend in ERAS development...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29318355/an-enhanced-recovery-after-surgery-eras-protocol-for-ambulatory-anorectal-surgery-reduced-postoperative-pain-and-unplanned-returns-to-care-after-discharge
#3
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29303803/postoperative-eras-interventions-have-the-greatest-impact-on-optimal-recovery-experience-with-implementation-of-eras-across-multiple-hospitals
#4
Mary-Anne Aarts, Ori D Rotstein, Emily A Pearsall, J Charles Victor, Allan Okrainec, Marg McKenzie, Stuart A McCluskey, Lesley Gotlib Conn, Robin S McLeod
BACKGROUND: Enhanced recovery after surgery (ERAS) programs incorporate evidence-based practices to minimize perioperative stress, gut dysfunction, and promote early recovery. However, it is unknown which components have the greatest impact. OBJECTIVE: This study aims to determine which components of ERAS programs have the largest impact on recovery for patients undergoing colorectal surgery. METHODS: An iERAS program was implemented in 15 academic hospitals...
January 4, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29302724/consensus-on-training-and-implementation-of-enhanced-recovery-after-surgery-a-delphi-study
#5
Nader K Francis, Thomas Walker, Fiona Carter, Martin Hübner, Angela Balfour, Dorthe Hjort Jakobsen, Jennie Burch, Tracy Wasylak, Nicolas Demartines, Dileep N Lobo, Valerie Addor, Olle Ljungqvist
BACKGROUND: Enhanced Recovery After Surgery (ERAS) is widely accepted in current surgical practice due to its positive impact on patient outcomes. The successful implementation of ERAS is challenging and compliance with protocols varies widely. Continual staff education is essential for successful ERAS programmes. Teaching modalities exist, but there remains no agreement regarding the optimal training curriculum or how its effectiveness is assessed. We aimed to draw consensus from an expert panel regarding the successful training and implementation of ERAS...
January 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29299662/the-association-between-intraoperative-fluid-intake-and-postoperative-complications-in-patients-undergoing-radical-cystectomy-with-an-enhanced-recovery-protocol
#6
Soroush T Bazargani, Saum Ghodoussipour, Beverly Tse, Gus Miranda, Jie Cai, Anne Schuckman, Siamak Daneshmand, Hooman Djaladat
PURPOSE: To evaluate the association between intraoperative fluid intake and postoperative complications in patients who underwent radical cystectomy (RC) for bladder cancer with an enhanced recovery protocol. METHODS: 287 patients underwent open RC with enhanced recovery protocol (ERAS) from 2012 to 2016. 107 were excluded; non-urothelial (30), palliative (37), had adjunct procedures or not-consented (40). We prospectively evaluated intraoperative fluid intake (crystalloid, colloid and blood) and correlated with length of stay, 30- and 90-day complications...
January 3, 2018: World Journal of Urology
https://www.readbyqxmd.com/read/29288246/enhanced-recovery-after-surgery-as-an-auditing-framework-for-identifying-improvements-to-perioperative-nutrition-care-of-older-surgical-patients
#7
Angela Byrnes, Merrilyn Banks, Alison Mudge, Adrienne Young, Judy Bauer
Older patients are at increased risk of malnutrition and reduced physical function. Using Enhanced Recovery After Surgery (ERAS) guidelines as an auditing framework, this study aimed to determine adherence of nutrition care to perioperative best practice in older patients. A single researcher retrieved data via chart review. Seventy-five consenting patients ≥65 years (median 72 (range 65-95) years, 61% male) admitted postoperatively to general surgical wards were recruited. Sixty per cent had a primary diagnosis of cancer and 51% underwent colorectal resection...
December 29, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29285407/designing-a-pain-management-protocol-for-craniotomy-a-narrative-review-and-consideration-of-promising-practices
#8
REVIEW
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29277176/-establishment-and-optimization-of-enhanced-recovery-after-surgery-system-%C3%A2-for-lung-cancer
#9
Guowei Che
With the development of key techniques and programs, the concept of enhanced recovery after surgery (ERAS) has been utilized in a wide range of diseases and surgical specialties. The key technological elements of enhanced lung recovery after surgery (ELRAS), which is regarded as the mainstay of minimally invasive lung cancer surgery, consist of the airway management and the lung protection. A multidisciplinary team cooperation based on physicians, nurses and rehabilitative therapists is needed to achieve the goals of airway management and lung protection, thus establishing a comprehensive ELRAS system for lung cancer patients...
December 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29275495/analysis-of-laparoscopic-sleeve-gastrectomy-learning-curve-and-its-influence-on-procedure-safety-and-perioperative-complications
#10
Piotr Major, Michał Wysocki, Jadwiga Dworak, Michał Pędziwiatr, Magdalena Pisarska, Mateusz Wierdak, Anna Zub-Pokrowiecka, Michał Natkaniec, Piotr Małczak, Michał Nowakowski, Andrzej Budzyński
PURPOSE: Laparoscopic sleeve gastrectomy (LSG) has become an attractive bariatric procedure with promising treatment effects yet amount of data regarding institutional learning process is limited. MATERIALS AND METHODS: Retrospective study included patients submitted to LSG at academic teaching hospital. Patients were divided into groups every 100 consecutive patients. LSG introduction was structured along with Enhanced Recovery after Surgery (ERAS) treatment protocol...
December 23, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29274837/dedicated-operating-room-teams-and-clinical-outcomes-in-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#11
Michael C Grant, Andrew Hanna, Andrew Benson, Deborah Hobson, Christopher L Wu, Christina T Yuan, Michael Rosen, Elizabeth C Wick
INTRODUCTION: To determine if the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery After Surgery (ERAS). ERAS programs involve the application of bundled best-practices to improve value of the perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. METHODS: Development of dedicated teams of anesthesia providers was a component of the ERAS implementation...
December 21, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29238571/immunonutrition-within-enhanced-recovery-after-surgery-eras-an-unresolved-matter
#12
EDITORIAL
Ruchir Gupta, Anthony Senagore
Preoperative malnutrition because of poor oral intake significantly increases the risk of adverse events after surgery and leads to increased length of stay. While immunonutrition has been utilized in the non-ERAS setting, its utility in both minimally invasive surgery and ERAS pathway procedures remain poorly defined. There are at least ten meta-analyses regarding the assessment of immunonutrition, but virtually, all of these were performed in an era prior to minimally invasive surgery, adoption of enhanced recovery protocols, and an understanding of the assessment and physiology of sarcopenia...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29234943/enhanced-recovery-care-versus-traditional-care-after-laparoscopic-liver-resections-a-randomized-controlled-trial
#13
Xiao Liang, Hanning Ying, Hongwei Wang, Hongxia Xu, Minjun Liu, Haiyan Zhou, Huiqing Ge, Wenbin Jiang, Lijun Feng, Hui Liu, Yingchun Zhang, Zhiying Mao, Jianhua Li, Bo Shen, Yuelong Liang, Xiujun Cai
BACKGROUND: Enhanced recovery after surgery (ERAS), with several evidence-based elements, has been shown to shorten length of hospital stay and reduce perioperative hospital costs in many operations. This randomized clinical trial was performed to compare complications and hospital stay of laparoscopic liver resection between ERAS and traditional care. METHODS: A randomized controlled trial was performed for laparoscopic liver resection from August 2015 to August 2016...
December 12, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29232645/pre-optimization-of-spinal-surgery-patients-development-of-a-neurosurgical-enhanced-recovery-after-surgery-eras-protocol
#14
Zarina S Ali, Tracy S Ma, Ali K Ozturk, Neil R Malhotra, James M Schuster, Paul J Marcotte, M Sean Grady, William C Welch
OBJECTIVE: Despite surgical, technological, medical, and anesthetic improvements, patient outcomes following elective neurosurgical procedures can be associated with high morbidity. Enhanced recovery after surgery (ERAS) protocols are multimodal care pathways designed to optimize patient outcomes by addressing pre-, peri-, and post-operative factors. Despite significant data suggesting improved patient outcomes with the adoption of these pathways, development and implementation has been limited in the neurosurgical population...
December 8, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29225618/influence-of-enhanced-recovery-pathway-on-surgical-site-infection-after-colonic-surgery
#15
Caroline Gronnier, Fabian Grass, Christiane Petignat, Basile Pache, Dieter Hahnloser, Giorgio Zanetti, Nicolas Demartines, Martin Hübner
Background: The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods: Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29220082/benefits-of-multimodal-enhanced-recovery-pathway-in-patients-undergoing-kidney-transplantation
#16
Kevin A Espino, J Reinier F Narvaez, Michael C Ott, Liise K Kayler
BACKGROUND: Use of enhanced recovery after surgery (ERAS) pathways to accelerate functional recovery and reduce length of stay (LOS) has rarely been investigated in kidney transplantation (KTX). MATERIALS AND METHODS: Consecutive adult isolated KTXs between July 2015 and July 2016 (ERAS, n = 139) were compared with a historical cohort between January 2014 and July 2015 (HISTORIC, n = 95). RESULTS: Enhanced recovery after surgery recipients were significantly more likely to receive kidneys that were non-local (56...
December 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#17
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29202716/prediction-of-postoperative-inflammatory-complications-after-esophageal-cancer-surgery-based-on-early-changes-in-the-c-reactive-protein-level-in-patients-who-received-perioperative-steroid-therapy-and-enhanced-recovery-after-surgery-care-a-retrospective-analysis
#18
Kazuki Kano, Toru Aoyama, Tetsushi Nakajima, Yukio Maezawa, Tsutomu Hayashi, Takanobu Yamada, Tsutomu Sato, Takashi Oshima, Yasushi Rino, Munetaka Masuda, Haruhiko Cho, Takaki Yoshikawa, Takashi Ogata
BACKGROUND: Serum C-reactive protein (CRP) level can be an indicator of the early stage of infectious complications. However, its utility in advanced esophageal cancer patients who receive radical esophagectomy with two- or three-field lymph node dissection with perioperative steroid therapy and enhanced recovery after surgery (ERAS) care is unclear. METHODS: The present study retrospectively examined 117 consecutive esophageal cancer patients who received neoadjuvant chemotherapy followed by radical esophagectomy...
December 4, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29201359/rationale-for-and-approach-to-preoperative-opioid-weaning-a-preoperative-optimization-protocol
#19
REVIEW
Heath McAnally
The practice of chronic opioid prescription for chronic non-cancer pain has come under considerable scrutiny within the past several years as mounting evidence reveals a generally unfavorable risk to benefit ratio and the nation reels from the grim mortality statistics associated with the opioid epidemic. Patients struggling with chronic pain tend to use opioids and also seek out operative intervention for their complaints, which combination may be leading to increased postoperative "acute-on-chronic" pain and fueling worsened chronic pain and opioid dependence...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29188453/can-the-combination-of-laparoscopy-and-enhanced-recovery-improve-long-term-survival-after-elective-colorectal-cancer-surgery
#20
N J Curtis, M Taylor, L Fraser, E Salib, E Noble, R Hipkiss, A S Allison, R Dalton, J B Ockrim, Nader K Francis
AIM: Enhanced recovery after surgery (ERAS) programmes and laparoscopic techniques both provide short-term benefits to patients undergoing colorectal cancer surgery. ERAS protocol compliance may improve long-term survival in those undergoing open colorectal resection but as laparoscopic data has not been reported. Therefore, we aimed to investigate the impact of the combination of laparoscopy and ERAS management on 5-year overall survival. METHODS: A dedicated prospectively populated colorectal cancer surgery database was reviewed...
November 29, 2017: International Journal of Colorectal Disease
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