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Enhanced recovery surgery

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https://www.readbyqxmd.com/read/28634646/the-role-of-robotics-in-the-invasive-management-of-bladder-cancer
#1
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Melanie Tan, Hilary Baker, James Thompson, Ashwin Sridhar, John D Kelly, Tim Briggs
Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28632542/creation-and-execution-of-a-novel-anesthesia-perioperative-care-service-at-a-veterans-affairs-hospital
#2
Bret D Alvis, Adam B King, Pratik P Pandharipande, Liza M Weavind, Katelin Avila, Philip J Leisy, Muhammad Ajmal, Michael McHugh, Kirk A Keegan, David A Baker, Ann Walia, Christopher G Hughes
Physician-led perioperative surgical home models are developing as a method for improving the American health care system. These models are novel, team-based approaches that help to provide continuity of care throughout the perioperative period. Another avenue for improving care for surgical patients is the use of enhanced recovery after surgery pathways. These are well-described methods that have shown to improve perioperative outcomes. An established perioperative surgical home model can help implementation, efficiency, and adherence to enhanced recovery after surgery pathways...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#3
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28623471/the-effect-of-intravenous-lidocaine-infusion-on-bispectral-index-during-major-abdominal-surgery
#4
Patrick Bazin, James Padley, Matthew Ho, Jennifer Stevens, Erez Ben-Menachem
Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1...
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28620897/enhanced-recovery-pathway-in-elderly-patients-undergoing-colorectal-surgery-is-there-an-effect-of-increasing-ages-results-from-the-perioperative-italian-society-registry
#5
Marco Braga, Luigi Beretta, Nicolò Pecorelli, Marianna Maspero, Umberto Casiraghi, Felice Borghi, Luca Pellegrino, Stefano Bona, Roberta Monzani, Gianluigi Ferrari, Danilo Radrizzani, Riccardo Iuliani, Carlo Bima, Marco Scatizzi, Giancarlo Missana, Marco Azzola Guicciardi, Andrea Muratore, Michele Crespi, Hedayat Bouzari, Andrea Pisani Ceretti, Ferdinando Ficari
Previous studies reported that enhanced recovery pathway (ERP) is safe in elderly who did not require a specifically tailored protocol. In previous studies, elderly have been considered as a homogeneous cohort and the cut-off value to identify them was different. The aim of the present study is to assess the compliance to ERP and its impact on postoperative outcome in three subgroups of elderly patients with increasing ages. Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed...
June 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28615506/modified-protocol-for-enhanced-recovery-after-surgery-is-beneficial-for-chinese-cancer-patients-undergoing-pancreaticoduodenectomy
#6
Xiaxing Deng, Xi Cheng, Zhen Huo, Yuan Shi, Zhijian Jin, Haoran Feng, Yue Wang, Chenlei Wen, Hao Qian, Ren Zhao, Weihua Qiu, Baiyong Shen, Chenghong Peng
Radical surgical resection remains the only effective treatment for advanced pancreatic cancer. Effective protocols for recovery from post-operative complications that result in high rates of morbidity and mortality are therefore essential. The enhanced recovery after surgery (ERAS) protocol is an interdisciplinary multimodal concept based on modern anesthesia and analgesia combined with other fast rehabilitation parameters. It was first applied in the field of elective colorectal surgery, and eventually extended to several surgical diseases...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28615302/ccr2-dependent-monocyte-derived-macrophages-resolve-inflammation-and-restore-gut-motility-in-postoperative-ileus
#7
Giovanna Farro, Michelle Stakenborg, Pedro J Gomez-Pinilla, Evelien Labeeuw, Gera Goverse, Martina Di Giovangiulio, Nathalie Stakenborg, Elisa Meroni, Francesca D'Errico, Yvon Elkrim, Damya Laoui, Zofia M Lisowski, Kristin A Sauter, David A Hume, Jo A Van Ginderachter, Guy E Boeckxstaens, Gianluca Matteoli
OBJECTIVE: Postoperative ileus (POI) is assumed to result from myeloid cells infiltrating the intestinal muscularis externa (ME) in patients undergoing abdominal surgery. In the current study, we investigated the role of infiltrating monocytes in a murine model of intestinal manipulation (IM)-induced POI in order to clarify whether monocytes mediate tissue damage and intestinal dysfunction or they are rather involved in the recovery of gastrointestinal (GI) motility. DESIGN: IM was performed in mice with defective monocyte migration to tissues (C-C motif chemokine receptor 2, Ccr2(-/ (-)) mice) and wild-type (WT) mice to study the role of monocytes and monocyte-derived macrophages (MΦs) during onset and resolution of ME inflammation...
June 14, 2017: Gut
https://www.readbyqxmd.com/read/28614595/perioperative-cox-2-inhibitors-may-increase-the-risk-of-post-operative-acute-kidney-injury
#8
A Abrahamsson, J Oras, J Snygg, L Block
BACKGROUND: In enhanced recovery protocols (ERP), a restrictive fluid regimen is proposed. Patients who undergo major surgery have an increased risk of post-operative acute kidney injury (AKI). This combination may pose difficulties when ERP is used for patients undergoing major surgery. The aim of this study was to evaluate whether patients undergoing pancreatic surgery and treated with a restrictive fluid regimen are at greater risk of post-operative AKI. Furthermore, if there was an increased risk of AKI, we aimed to identify its cause...
June 14, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28608958/meta-analysis-of-hybrid-natural-orifice-transluminal-endoscopic-surgery-versus-laparoscopic-surgery
#9
REVIEW
D C Steinemann, P C Müller, P Probst, A-C Schwarz, M W Büchler, B P Müller-Stich, G R Linke
BACKGROUND: Hybrid natural-orifice transluminal endoscopic surgery (NOTES), combining access through a natural orifice with small-sized abdominal trocars, aims to reduce pain and enhance recovery. The objective of this systematic review and meta-analysis was to compare pain and morbidity in hybrid NOTES and standard laparoscopy. METHODS: A systematic literature search was performed to identify RCTs and non-RCTs comparing hybrid NOTES and standard laparoscopy. The main outcome was pain on postoperative day (POD) 1...
July 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28607888/postoperative-pain-in-adult-tonsillectomy-is-there-any-difference-between-the-technique
#10
Itziar Álvarez Palacios, Ricardo González-Orús Álvarez-Morujo, Cristina Alonso Martínez, Alejandra Ayala Mejías, Oscar Arenas Brítez
Tonsillectomy is one of the most common surgical procedures performed worldwide. Several techniques have been developed to reduce morbidity and enhance recovery after tonsillectomy. Our study was designed to compare post-operative pain with three different techniques: cold dissection (CD), monopolar-bipolar dissection (MBD) and coblation dissection (CBD). 103 adults were scheduled for elective tonsillectomy from September 2014 to December 2015, and were randomized to CD, MBD and CBD. Post-operative pain was assessed using visual analogue scale (VAS) and Lattinen Test (LT)...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28607851/order-sets-for-enhanced-recovery-after-surgery-protocol
#11
Melissa Shea-Budgell, Christiaan Schrag, Danielle Dumestre, Arezoo Astanehe, Claire Temple-Oberle
No abstract text is available yet for this article.
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28604179/bolus-administration-of-intravenous-lidocaine-reduces-pain-after-an-elective-caesarean-section-findings-from-a-randomised-double-blind-placebo-controlled-trial
#12
Afshin Gholipour Baradari, Abolfazl Firouzian, Farshad Hasanzadeh Kiabi, Amir Emami Zeydi, Mohammad Khademloo, Zeinab Nazari, Masoumeh Sanagou, Maedeh Ghobadi, Ensieh Fooladi
We conducted a randomised double-blind, placebo-controlled trial to assess whether a bolus dose of lidocaine during the induction of general anaesthesia would reduce postoperative pain over 24 h. Level of satisfaction with pain control at 48 h after surgery and Apgar score were also examined. A total of 100 women aged 20-35 years, who were candidates for elective caesarean section (CS) were randomised to receive either 1.5 mg/kg lidocaine or placebo during the induction of general anaesthesia. Results showed that lidocaine decreased pain intensity over 24 h after surgery (p < ...
July 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28602223/is-enhanced-recovery-enough-for-reducing-30-d-readmissions-after-surgery
#13
Anne C Fabrizio, Michael C Grant, Zishan Siddiqui, Yewande Alimi, Susan L Gearhart, Christopher Wu, Jonathan E Efron, Elizabeth C Wick
BACKGROUND: Few enhanced recovery pathways (ERPs) include processes related to the hospital to home transfer. Little has been reported regarding readmissions in enhanced recovery programs. This study evaluates readmissions and identifies areas to optimize ERPs to prevent readmissions. METHODS: We conducted an observational, retrospective study at a single tertiary care center. Patients in an ERP for colorectal surgery were compared with a similar cohort who underwent surgery before protocol implementation...
April 22, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28595547/beneficial-effects-of-n-acetylcysteine-and-n-mercaptopropionylglycine-on-ischemia-reperfusion-injury-in-the-heart
#14
Monika Bartekova, Miroslav Barancik, Kristina Ferenczyova, Narajan S Dhalla
Ischemia-reperfusion (I/R) injury of the heart as a consequence of myocardial infarction or cardiac surgery represents a serious clinical problem. One of the most prominent mechanisms of I/R injury is the development of oxidative stress in the heart. In this regard, I/R has been shown to enhance the production of reactive oxygen/nitrogen species in the heart which lead to the imbalance between the pro-oxidants and antioxidant capacities of the endogenous radical-scavenging systems. Accordingly, increasing the antioxidant capacity of the heart by the administration of exogenous antioxidants is considered beneficial for the heart exposed to I/R...
June 8, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28594746/enhanced-recovery-after-surgery-eras-eliminates-racial-disparities-in-postoperative-length-of-stay-after-colorectal-surgery
#15
Tyler S Wahl, Lauren E Goss, Melanie S Morris, Allison A Gullick, Joshua S Richman, Gregory D Kennedy, Jamie A Cannon, Selwyn M Vickers, Sara J Knight, Jeffrey W Simmons, Daniel I Chu
OBJECTIVE: To investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. BACKGROUND: Racial disparities in surgical outcomes exist. We hypothesized that ERAS would reduce disparities in pLOS between black and white patients. METHODS: Patients undergoing ERAS in 2015 were 1:1 matched by race/ethnicity, age, sex, and procedure to a pre-ERAS group from 2010 to 2014...
June 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28593411/c-reactive-protein-fibrinogen-and-procalcitonin-levels-as-early-markers-of-staple-line-leak-after-laparoscopic-sleeve-gastrectomy-in-morbidly-obese-patients-within-an-enhanced-recovery-after-surgery-eras-program
#16
Jaime Ruiz-Tovar, Jose Luis Muñoz, Juan Gonzalez, Alejandro Garcia, Carlos Ferrigni, Montiel Jimenez, Manuel Duran
INTRODUCTION: The performance of most bariatric procedures within an Enhanced Recovery After Surgery program has resulted in significant advantages, including a reduction in the length of hospital stay to 2-3 days. However, some postoperative complications may appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 h after a laparoscopic sleeve gastrectomy for predicting staple line leak in the postoperative course...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28593407/feasibility-of-real-time-location-systems-in-monitoring-recovery-after-major-abdominal-surgery
#17
Robert D Dorrell, Sarah A Vermillion, Clancy J Clark
BACKGROUND: Early mobilization after major abdominal surgery decreases postoperative complications and length of stay, and has become a key component of enhanced recovery pathways. However, objective measures of patient movement after surgery are limited. Real-time location systems (RTLS), typically used for asset tracking, provide a novel approach to monitoring in-hospital patient activity. The current study investigates the feasibility of using RTLS to objectively track postoperative patient mobilization...
June 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28592601/the-enhanced-recovery-after-surgery-eras-program-benefit-and-concerns
#18
Peter B Soeters
No abstract text is available yet for this article.
June 7, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28570271/delayed-decompression-exacerbates-ischemia-reperfusion-injury-in-cervical-compressive-myelopathy
#19
Pia M Vidal, Spyridon K Karadimas, Antigona Ulndreaj, Alex M Laliberte, Lindsay Tetreault, Stefania Forner, Jian Wang, Warren D Foltz, Michael G Fehlings
Degenerative cervical myelopathy (DCM) is the most common progressive nontraumatic spinal cord injury. The most common recommended treatment is surgical decompression, although the optimal timing of intervention is an area of ongoing debate. The primary objective of this study was to assess whether a delay in decompression could influence the extent of ischemia-reperfusion injury and alter the trajectory of outcome in DCM. Using a DCM mouse model, we show that decompression acutely led to a 1.5- to 2-fold increase in levels of inflammatory cytokines within the spinal cord...
June 2, 2017: JCI Insight
https://www.readbyqxmd.com/read/28564673/postoperative-multimodal-analgesia-pain-management-with-nonopioid-analgesics-and-techniques-a-review
#20
Elizabeth C Wick, Michael C Grant, Christopher L Wu
Importance: Amid the current opioid epidemic in the United States, the enhanced recovery after surgery pathway (ERAS) has emerged as one of the best strategies to improve the value and quality of surgical care and has been increasingly adopted for a broad range of complex surgical procedures. The goal of this article was to outline important components of opioid-sparing analgesic regimens. Observations: Regional analgesia, acetaminophen, nonsteroidal anti-inflammatory agents, gabapentinoids, tramadol, lidocaine, and/or the N-methyl-d-aspartate class of glutamate receptor antagonists have been shown to be effective adjuncts to narcotic analgesia...
May 31, 2017: JAMA Surgery
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