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Enhanced recovery after surgery

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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/29779305/-expert-consensus-on-standardized-processes-of-ambulatory-biliary-surgery-2018-edition
#4
(no author information available yet)
The definition of ambulatory surgery is that the patient is admitted, operated and discharged within a day (24 hours) , but does not include outpatient surgery. It can shorten the average hospital stay, reduce medical expenses, accelerate the recovery of patients, and has been approved to have great social and economic benefits.The main contents of this consensus include: (1)the establishment of ambulatory biliary surgery system, which involves the facilities building, team building, the construction of management systems, operation management, operation state analysis and benefit evaluation; (2)Patient selection criteria, pre-hospital assessment, surgical scheduling, preoperative education, anesthesia and management of adverse reactions after anesthesia, intraoperative application of general surgical principles and postoperative emergency plans, perioperative nursing; (3)Discharge criteria and pre-discharge assessment, post-discharge follow-up and rehabilitation guidance; (4) quality and safety control index system of ambulatory biliary surgery...
May 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29778441/hypoxic-postconditioning-enhances-functional-recovery-following-endothelin-1-induced-middle-cerebral-artery-occlusion-in-conscious-rats
#5
Hong L Nguyen, Alexander M Ruhoff, Thomas Fath, Nicole M Jones
Stroke is a leading cause of death and a major contributor to neurological disability in adults. Tissue plasminogen activator is the only approved treatment. However, due to its narrow therapeutic window, <5% of patients receive treatment. Recently, hypoxic postconditioning (HPC) was shown to reduce stroke induced-injury in mice, but the mechanisms and functional outcomes are still unknown. In the current study, male Sprague Dawley rats were subjected to endothelin-1 induced stroke. HPC (8% O2 , 1 h/d for 5d) or normoxia treatments were started 24 h after stroke...
May 17, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29777454/improved-outcomes-in-394-pancreatic-cancer-resections-the-impact-of-enhanced-recovery-pathway
#6
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/29775143/testing-the-effectiveness-and-the-contribution-of-experimental-supercharge-reversed-end-to-side-nerve-transfer
#7
Mustafa Nadi, Sudheesh Ramachandran, Abir Islam, Joanne Forden, Gui Fang Guo, Rajiv Midha
OBJECTIVE Supercharge end-to-side (SETS) transfer, also referred to as reverse end-to-side transfer, distal to severe nerve compression neuropathy or in-continuity nerve injury is gaining clinical popularity despite questions about its effectiveness. Here, the authors examined SETS distal to experimental neuroma in-continuity (NIC) injuries for efficacy in enhancing neuronal regeneration and functional outcome, and, for the first time, they definitively evaluated the degree of contribution of the native and donor motor neuron pools...
May 18, 2018: Journal of Neurosurgery
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
#8
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/29774638/loss-of-sirtuin-1-and-mitofusin-2-contributes-to-enhanced-ischemia-reperfusion-injury-in-aged-livers
#9
Sung Kook Chun, Sooyeon Lee, Joseph Flores-Toro, Rebecca Y U, Ming-Jim Yang, Kristina L Go, Thomas G Biel, Catherine E Miney, Schiley Pierre Louis, Brian K Law, Mary E Law, Elizabeth M Thomas, Kevin E Behrns, Christiaan Leeuwenburgh, Jae-Sung Kim
Ischemia/reperfusion (I/R) injury is a causative factor contributing to morbidity and mortality during liver resection and transplantation. Livers from elderly patients have a poorer recovery from these surgeries, indicating reduced reparative capacity with aging. Mechanisms underlying this age-mediated hypersensitivity to I/R injury remain poorly understood. Here, we investigated how sirtuin 1 (SIRT1) and mitofusin 2 (MFN2) are affected by I/R in aged livers. Young (3 months) and old (23-26 months) male C57/BL6 mice were subjected to hepatic I/R in vivo...
May 17, 2018: Aging Cell
https://www.readbyqxmd.com/read/29772592/-cardiac-anaesthesia-anaesthesiological-management
#10
Jochen Renner, Berthold Bein, Ole Broch
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29772271/pain-management-after-bone-reconstruction-surgery-using-an-analgesic-bone-cement-a-functional-non-invasive-in-vivo-study-using-gait-analysis
#11
Manon Dupleichs, Martial Masson, Olivier Gauthier, Maeva Dutilleul, Jean-Michel Bouler, Elise Verron, Pascal Janvier
Postoperative pain following bone reconstruction is a serious complication that could jeopardize the global success of a surgery. This pain must be controlled and minimized during the first 3-4 postoperative days to prevent it from becoming chronic. In this study, a critical-size bone defect was created at the femoral distal end of rats and filled by an injectable calcium phosphate cement (CPC) loaded or not with local anesthetics (bupivacaine or ropivacaine). A functional evaluation of the gait was performed using the CatWalk system to compare the postoperative pain relief enhanced by the different CPCs after such a bone filling surgery...
May 14, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29772001/correction-using-the-normalization-process-theory-to-qualitatively-explore-sense-making-in-implementation-of-the-enhanced-recovery-after-surgery-programme-it-s-not-rocket-science
#12
Eileen Sutton, Georgia Herbert, Sorrel Burden, Stephen Lewis, Steve Thomas, Andy Ness, Charlotte Atkinson
[This corrects the article DOI: 10.1371/journal.pone.0195890.].
2018: PloS One
https://www.readbyqxmd.com/read/29771797/measuring-in-hospital-recovery-after-colorectal-surgery-within-a-well-established-enhanced-recovery-pathway-a-comparison-between-hospital-length-of-stay-and-time-to-readiness-for-discharge
#13
Saba Balvardi, Nicolò Pecorelli, Tanya Castelino, Petru Niculiseanu, A Sender Liberman, Patrick Charlebois, Barry Stein, Franco Carli, Nancy E Mayo, Liane S Feldman, Julio F Fiore
BACKGROUND: Hospital length of stay is often used as a measure of in-hospital recovery but may be confounded by organizational factors. Time to readiness for discharge may provide a superior index of recovery. OBJECTIVE: The purpose of this study was to contribute evidence for the construct validity of time to readiness for discharge and length of stay as measures of in-hospital recovery after colorectal surgery in the context of a well-established enhanced recovery pathway...
May 15, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29770203/enhanced-recovery-after-cesarean-delivery
#14
REVIEW
Unyime Ituk, Ashraf S Habib
Enhanced recovery after surgery is a concept initially developed for patients undergoing colorectal surgery but has been adopted by other surgical specialties with similar positive outcomes. The adoption of enhanced recovery after surgery in the obstetric patient population is rapidly gaining popularity. This review highlights perioperative interventions that should be considered in an enhanced recovery after surgery protocol for women undergoing cesarean delivery.
2018: F1000Research
https://www.readbyqxmd.com/read/29765320/distinct-analgesic-actions-of-dha-and-dha-derived-specialized-pro-resolving-mediators-on-post-operative-pain-after-bone-fracture-in-mice
#15
Linlin Zhang, Niccolò Terrando, Zhen-Zhong Xu, Sangsu Bang, Sven-Eric Jordt, William Maixner, Charles N Serhan, Ru-Rong Ji
Mechanisms of pain resolution are largely unclear. Increasing evidence suggests that specialized pro-resolving mediators (SPMs), derived from fish oil docosahexaenoic acid (DHA), promote the resolution of acute inflammation and potently inhibit inflammatory and neuropathic pain. In this study, we examined the analgesic impact of DHA and DHA-derived SPMs in a mouse model of post-operative pain induced by tibial bone fracture (fPOP). Intravenous perioperative treatment with DHA (500 μg), resolvin D1 (RvD1, 500 ng) and maresin 1 (MaR1, 500 ng), 10 min and 24 h after the surgery, delayed the development of fPOP (mechanical allodynia and cold allodynia)...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29762216/enhanced-recovery-after-surgery-is-it-time-to-drive-patient-reported-outcomes-through-robust-measurement
#16
Lee A Fleisher, Clifford Y Ko
No abstract text is available yet for this article.
June 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29761863/surgical-treatment-of-esophageal-cancer-in-the-era-of-multimodality-management
#17
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/29756520/sustainability-of-an-enhanced-recovery-program-for-pancreaticoduodenectomy-with-pancreaticogastrostomy
#18
C Williamsson, T Karlsson, M Westrin, D Ansari, R Andersson, B Tingstedt
BACKGROUND: Enhanced recovery program for pancreaticoduodenectomy have become standard care. Little is known about adherence rates and sustainability of the program, especially when pancreaticogastrostomy is used in reconstruction. The aim of this study was, therefore, to evaluate adherence rates and continued outcome, after implementation of an enhanced recovery program. METHODS: Consecutive patients undergoing pancreaticoduodenectomy at the Department of Surgery, Skåne University Hospital, Lund, Sweden were followed, after implementation of enhanced recovery program, October 2012...
May 1, 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29754619/enhanced-recovery-after-surgery-protocols-rationale-and-components
#19
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
#20
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
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