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Enhanced recovery surgery

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https://www.readbyqxmd.com/read/28440529/-implementation-of-enhanced-recovery-after-surgery-in-nutritional-management-of-patients-undergoing-metabolic-surgery
#1
Tianzi Zhang, Qin Xu, Ningli Yang, Juan Tang, Hui Liang
Metabolic surgery is a gastrointestinal surgical procedure to treat obesity and its related co-morbidities with rapid development in recent years. Patients undergoing metabolic surgery have preoperative nutritional disorders, and the nutrition management for these patients is the key point of perioperative management. During the perioperative period, current research has preliminarily confirmed that perioperative managements including supplementation of micronutrients, preoperative evaluation of the weight loss, preoperative fasting and carbohydrate oral intake based on the full application of ERAS and characteristics of the patients undergoing metabolic surgery, are safe and effective in clinical practice...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28437313/enhanced-recovery-after-surgery-for-noncolorectal-surgery-a-systematic-review-and-meta-analysis-of-major-abdominal-surgery
#2
Anthony Visioni, Rupen Shah, Emmanuel Gabriel, Kristopher Attwood, Moshim Kukar, Steven Nurkin
OBJECTIVE: To evaluate the impact of enhanced recovery after surgery (ERAS) protocols across noncolorectal abdominal surgical procedures. BACKGROUND: ERAS programs have been studied extensively in colorectal surgery and adopted at many centers. Several studies testing such protocols have shown promising results in improving postoperative outcomes across various surgical procedures. However, surgeons performing major abdominal procedures have been slower to adopt these ERAS protocols...
April 21, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28425574/factors-associated-with-sustainability-of-2-quality-improvement-programs-after-achieving-early-implementation-success-a-qualitative-case-study
#3
Stephanie M C Ament, Freek Gillissen, Albine Moser, José M C Maessen, Carmen D Dirksen, Maarten F von Meyenfeldt, Trudy van der Weijden
RATIONALE, AIMS, AND OBJECTIVES: Sustainability of innovations is a relatively new concept in health care research and has become an issue of growing interest. The current study explored factors related to the sustainability of 2 multidisciplinary hospital-based programs 3 to 6 years after achieving early implementation success. METHOD: An exploratory qualitative study was conducted into 2 implementation cases, an Enhanced Recovery After Surgery program for colorectal surgery and a short-stay program for breast cancer surgery...
April 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28424140/impact-of-multimodality-pain-regimens-on-elective-colorectal-surgery-outcomes
#4
Jennifer A Kaplan, Emily Finlayson, Andrew D Auerbach
Trials of enhanced recovery programs suggest that multimodality pain regimens improve outcomes after colorectal surgery. We sought to determine whether patients receiving postoperative multimodality pain regimens would have shorter lengths of stay without an associated increase in readmission rate as compared to those receiving opioid-based pain regimens. Retrospective cohort study of adults who underwent elective colorectal surgery between January 1, 2006, and December 31, 2012, in a national hospital network participating in the Premier Perspective database...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28418820/case-241-hemiparkinsonism-hemiatrophy-spect-with-99m-tc-trodat-1-and-muscle-mr-imaging-abnormalities
#5
Thiago Cardoso Vale, Flávia Cristina de Lima Pinto, José Luiz Pedroso, Marília Alves Dos Reis, Ilza Rosa Batista, Rodrigo Affonseca Bressan, René Leandro Magalhães Rivero, Renato Adam Mendonça, Orlando G Barsottini
History A 43-year-old right-handed man presented with a history of progressive mild left-sided weakness and slowness of movements. Symptoms began 4 years earlier, and the patient noticed a progressive decline in his daily routine due to gait difficulties in the past year. There was no history of head trauma, surgery, drug therapy, smoking, or alcohol abuse, nor was there any relevant family history. Examination revealed normal cognition (29 of 30 points on the Mini-Mental State Examination and 27 of 30 points on the Montreal Cognitive Assessment) and normal cerebellar, sensory, cranial nerve, and autonomic function...
May 2017: Radiology
https://www.readbyqxmd.com/read/28415885/fatigue-and-pain-limit-independent-mobility-and-physiotherapy-after-hip-fracture-surgery
#6
Kristine H Münter, Christopher G Clemmesen, Nicolai B Foss, Henrik Palm, Morten T Kristensen
PURPOSE: The patient's ability to complete their planned physiotherapy session after hip fracture surgery has been proposed as an independent predictor for achieving basic mobility independency upon hospital discharge. However, knowledge of factors limiting mobility is sparse. We therefore examined patient reported factors limiting ability to complete planned physiotherapy sessions as well as limitations for not achieving independency in basic mobility early after hip fracture surgery...
April 17, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28414709/robotic-surgery-fast-forward-to-telemedicine
#7
George B Stefano
Since the realization that certain maladies can be corrected via surgical techniques, we have been consumed by the desire to constantly advance the tools of surgery, as well as the techniques. In recent times, computer-assisted surgical tools have emerged and are growing in their use. The Puma 560 emerged in 1985 for brain biopsies and laparoscopic surgery. Prostatic surgery was performed by the Probot in 1988. In 1992, fittings in the femur were placed using the ROBODOC. These early robotic endeavors gave rise to AESOP, ZEUS and the relatively intuitive da Vinci® Surgical System...
April 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28413629/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-1-from-the-preoperative-period-to-pacu
#8
Matthew D McEvoy, Michael J Scott, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413628/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#9
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28410831/feasibility-and-efficacy-of-presurgical-exercise-in-survivors-of-rectal-cancer-scheduled-to-receive-curative-resection
#10
Favil Singh, Robert U Newton, Michael K Baker, Nigel A Spry, Dennis R Taaffe, Daniel A Galvão
BACKGROUND: Localized rectal carcinoma is invasive, with surgical resection the standard treatment. The aim of this study was to determine the feasibility of a supervised presurgical exercise intervention in patients with rectal cancer prior to rectal resection. PATIENTS AND METHODS: Twelve patients volunteered to undertake twice-weekly aerobic and resistance exercise for ∼16 weeks prior to surgery. At baseline, presurgery, and ∼8 weeks postsurgery, muscle strength and physical performance, body composition, quality of life, and fatigue were assessed...
March 21, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28404067/continuous-wound-infiltration-versus-epidural-analgesia-after-hepato-pancreato-biliary-surgery-pop-up-a-randomised-controlled-open-label-non-inferiority-trial
#11
Timothy H Mungroop, Denise P Veelo, Olivier R Busch, Susan van Dieren, Thomas M van Gulik, Tom M Karsten, Steve M de Castro, Marc B Godfried, Bram Thiel, Markus W Hollmann, Philipp Lirk, Marc G Besselink
BACKGROUND: Epidural analgesia is the international standard for pain treatment in abdominal surgery. Although some studies have advocated continuous wound infiltration with local anaesthetics, robust evidence is lacking, especially on patient-reported outcome measures. We aimed to determine the effectiveness of continuous wound infiltration in hepato-pancreato-biliary surgery. METHODS: In this randomised controlled, open label, non-inferiority trial (POP-UP), we enrolled adult patients undergoing hepato-pancreato-biliary surgery by subcostal or midline laparotomy in two Dutch hospitals...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403415/enhanced-recovery-after-surgery-for-hip-and-knee-arthroplasty-where-is-the-evidence
#12
H Kehlet
No abstract text is available yet for this article.
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403408/systemic-lidocaine-fails-to-improve-postoperative-morphine-consumption-postoperative-recovery-and-quality-of-life-in-patients-undergoing-posterior-spinal-arthrodesis-a-double-blind-randomized-placebo-controlled-trial
#13
G Dewinter, P Moens, S Fieuws, B Vanaudenaerde, M Van de Velde, S Rex
Background.: It is inconclusive whether the perioperative administration of systemic lidocaine provides effective postoperative analgesia and enhances recovery in major orthopaedic surgery. We hypothesised that in adolescent and adult patients undergoing posterior spinal arthrodesis, a perioperative lidocaine infusion would reduce opioid requirements during the first 24 postoperative h. Methods.: 70 patients undergoing posterior arthrodesis were enrolled in this prospective, randomised, double-blind, placebo-controlled clinical trial...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403398/systematic-review-of-the-systemic-concentrations-of-local-anaesthetic-after-transversus-abdominis-plane-block-and-rectus-sheath-block
#14
J Rahiri, J Tuhoe, D Svirskis, N J Lightfoot, P B Lirk, A G Hill
Background.: Safe and efficacious modalities of perioperative analgesia are essential for enhanced recovery after surgery. Truncal nerve blocks are one potential adjunct for analgesia of the abdominal wall, and in recent years their popularity has increased. Transversus abdominis plane block (TAPB) and rectus sheath block (RSB) have been shown to reduce morphine consumption and improve pain relief after abdominal surgery. These blocks typically require large volumes of local anaesthetic (LA)...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403075/gabapentin-can-decrease-acute-pain-and-morphine-consumption-in-spinal-surgery-patients-a-meta-analysis-of-randomized-controlled-trials
#15
Chuangang Peng, Chen Li, Ji Qu, Dankai Wu
BACKGROUND: Approximately 80% of patients who underwent spinal surgeries experience moderate to extreme postoperative pain. Gabapentin was used as an adjunct for the management of acute pain in approximately half of enhanced recovery programs. This meta-analysis aimed to illustrate the efficacy and safety of gabapentin for pain management following spinal surgery. METHODS: In January 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28400664/enhanced-recovery-protocol-and-hidden-blood-loss-in-patients-undergoing-total-knee-arthroplasty
#16
Rohit Dhawan, Harshadkumar Rajgor, Rathan Yarlagadda, John John, Niall M Graham
BACKGROUND: Perioperative blood loss and postoperative pain following total knee arthroplasty prevent early mobilisation of patients. The Enhanced Recovery Protocol (ERP) followed for patients in our institute aims at reducing post operative pain, blood loss and length of stay. MATERIALS AND METHODS: 50 consecutive patients that underwent ERP following total knee arthroplasty with another group of 70 patients that underwent the same surgery without ERP were compared in terms of hidden blood loss and length of hospital stay...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28398964/postacute-care-and-recovery-after-cancer-surgery-still-a-long-way-to-go
#17
Courtney J Balentine, Peter A Richardson, Meredith C Mason, Aanand D Naik, David H Berger, Daniel A Anaya
OBJECTIVE: To determine whether postacute care (PAC) facilities can compensate for increased mortality stemming from a complicated postoperative recovery (complications or deconditioning). BACKGROUND: An increasing number of patients having cancer surgery rely on PAC facilities including skilled nursing and rehabilitation centers to help them recover from postoperative complications and the physical demands of surgery. It is currently unclear whether PAC can successfully compensate for the adverse consequences of a complicated postoperative recovery...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28398962/population-based-assessment-of-intraoperative-fluid-administration-practices-across-three-surgical-specialties
#18
Scott E Regenbogen, Nirav J Shah, Stacey D Collins, Samantha Hendren, Michael J Englesbe, Darrell A Campbell
OBJECTIVE: To assess the variation in hospitals' approaches to intraoperative fluid management and their association with postoperative recovery. BACKGROUND: Despite increasing interest in goal-directed, restricted-volume fluid administration for major surgery, there remains little consensus on optimal strategies, due to the lack of institution-level studies of resuscitation practices. METHODS: Among 64 hospitals in a state-wide surgical collaborative, we profiled fluid administration practices during 8404 intestinal resections, 22,854 hysterectomies, and 1471 abdominopelvic endovascular procedures...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28390846/-surgeons-anesthetists-relations-from-an-individual-responsibility-of-the-surgeon-to-a-shared-responsibility-with-the-anesthetist
#19
Philip Cohen, Karem Slim, Laure Soulier, Alexandre Theissen
Throughout the perioperative period, anesthetists and surgeons jointly provide care for patients. The advances in medicine and surgery, the practice of perioperative quality medicine and the recent application of enhanced recovery program after surgery have necessitated strengthening the place of each in its area of expertise while developing the spirit team and communication. Thus, alongside the surgeon who was once considered the head of the surgical team, the anesthetist's role has been to consolidate for the management of the surgical patient and had his spot empower themselves in the eye of the patient with the birth an own contract with the patient (due in particular to the obligation to preanesthetic consultation by the decree of December 5, 1994)...
April 5, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28389089/how-can-recovery-be-enhanced-after-single-stage-laparoscopic-management-of-cbd-stones-endoscopic-treatment-versus-laparoscopic-surgery
#20
Emilie Chapuis-Roux, Laurent Pellissier, Francois Browet, Jean Charles Berthou, Sami Hakim, Franck Brazier, Cyril Cosse, Richard Delcenserie, Jean Marc Regimbeau
BACKGROUND: Single-stage management of CBD stones comprises simultaneous common bile duct (CBD) clearance and cholecystectomy. The CBD can be cleared by using endoscopic treatment (ET) or laparoscopic surgery (LS) alone. AIMS: To determine the most rapid recovery after the single-stage laparoscopic management of CBD stones. METHODS: Patients with CBD stones treated at either of two centers (one performing ET only and one performing LS only for single-stage treatment) were included...
March 22, 2017: Digestive and Liver Disease
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