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Enhanced recovery after surgery

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https://www.readbyqxmd.com/read/28079776/enhanced-recovery-program-and-length-of-stay-after-laparotomy-on-a-gynecologic-oncology-service-a-randomized-controlled-trial
#1
Elizabeth L Dickson, Erica Stockwell, Melissa A Geller, Rachel Isaksson Vogel, Sally A Mullany, Rahel Ghebre, Boris J N Witherhoff, Levi S Downs, Linda F Carson, Deanna Teoh, Michelle Glasgow, Matt Gerber, Colleen Rivard, Britt K Erickson, Jacob Hutchins, Peter A Argenta
OBJECTIVE: To estimate whether a rapid recovery program would reduce length of stay among patients undergoing laparotomy on a gynecologic oncology service. METHODS: We conducted a prospective, randomized, controlled trial comparing an enhanced recovery after surgery protocol with routine postoperative care among women undergoing laparotomy on the gynecologic oncology service. Protocol elements included: preoperative counseling, regional anesthesia, intraoperative fluid restriction, and early postoperative ambulation and feeding...
January 9, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28079734/thoracic-epidural-anesthesia-and-prophylactic-three-times-daily-unfractionated-heparin-within-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#2
Alexander B Stone, Michael C Grant, Brandyn D Lau, Deborah B Hobson, Michael B Streiff, Elliot R Haut, Christopher L Wu, Elizabeth C Wick
BACKGROUND AND OBJECTIVES: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. METHODS: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center...
January 9, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28073188/effects-of-obesity-surgery-laparoscopic-sleeve-gastrectomy-technique-on-lower-urinary-tract-symptoms-depression-and-quality-of-life-of-males-prospective-study
#3
Fatih Uruç, Serkan Akan, Bekir Aras, Çaglar Yıldırım, Aytaç Sahin, Ozgur Haki Yuksel, Mehmet Timuçin Aydın, Ayhan Verit
PURPOSE: Technically, obesity weakens the pelvic base muscles by causing an increase in the intraabdominal pressure and intravesical pressure due to increasing fat and it triggers the occurrence of lower urinary tract symptoms. However it is believed that weight loss will cause recovery of these symptoms. Our purpose in this study is to research about the effects of the weight loss achieved by using especially the Laparoscopic Sleeve Gastrectomy (LSG) technique of bariatric surgery which is being more and more widely used today...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28062937/protocol-for-enhanced-recovery-after-surgery-improves-short-term-outcomes-for-patients-with-gastric-cancer-a-randomized-clinical-trial
#4
Ryo Tanaka, Sang-Woong Lee, Masaru Kawai, Keitaro Tashiro, Satoshi Kawashima, Syuji Kagota, Kotaro Honda, Kazuhisa Uchiyama
BACKGROUND: The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear. METHODS: This study was a single-center, prospective randomized trial involving patients with gastric cancer undergoing curative gastrectomy. The primary end point was the length of postoperative hospital stay. Secondary end points were the postoperative complication rate, admission costs, weight loss, and amount of physical activity...
January 6, 2017: Gastric Cancer
https://www.readbyqxmd.com/read/28062329/managing-symptoms-enhancing-patients-self-management-knowledge-and-skills-for-surgical-recovery
#5
REVIEW
Jan Odom-Forren, Susan Wesmiller
OBJECTIVES: To review postoperative symptoms experienced by patients following surgery for cancer and discuss focused, evidenced-based methods to teach the patient acute pain and symptom management to include both pharmacological and non-pharmacological strategies. DATA SOURCES: Peer reviewed articles and national guidelines. CONCLUSION: Although significant advances have been made in providing effective acute pain control, pain remains a serious consequence after cancer surgery...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28059919/reducing-readmissions-while-shortening-length-of-stay-the-positive-impact-of-an-enhanced-recovery-protocol-in-colorectal-surgery
#6
Puja M Shah, Lily Johnston, Bethany Sarosiek, Amy Harrigan, Charles M Friel, Robert H Thiele, Traci L Hedrick
BACKGROUND: Hospital readmission rates are an increasingly important quality metric since enactment of the 2012 Hospital Readmissions Reduction Program. The proliferation of enhanced recovery protocols and earlier discharge raises concerns for increased readmission rates. OBJECTIVE: We evaluated the effect of enhanced recovery on readmissions and identified risk factors for readmission. DESIGN: This study involved implementation of a multidisciplinary enhanced recovery protocol...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059913/liposomal-bupivacaine-use-in-transversus-abdominis-plane-blocks-reduces-pain-and-postoperative-intravenous-opioid-requirement-after-colorectal-surgery
#7
Audrey L Stokes, Sanjib D Adhikary, Ashley Quintili, Frances J Puleo, Christine S Choi, Christopher S Hollenbeak, Evangelos Messaris
BACKGROUND: Enhanced recovery protocols frequently use multimodal postoperative analgesia to improve postoperative outcomes in patients undergoing colorectal surgery. OBJECTIVE: The purpose of this study was to evaluate liposomal bupivacaine use in transversus abdominis plane blocks on postoperative pain scores and opioid use after colorectal surgery. DESIGN: This was a retrospective cohort study comparing outcomes between patients receiving nonliposomal anesthetic (n = 104) and liposomal bupivacaine (n = 303) blocks...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28054356/impact-of-a-peri-operative-quality-improvement-programme-on-postoperative-pulmonary-complications
#8
J A Moore, D H Conway, N Thomas, D Cummings, D Atkinson
Postoperative pulmonary complications are common, with a reported incidence of 2-40%, and are associated with adverse outcomes that include death, longer hospital stay and reduced long-term survival. Enhanced recovery is now a standard of care for patients undergoing elective major surgery. Despite the high prevalence of pulmonary complications in this population, few elements of enhanced recovery specifically address reducing these complications. In 2013, a prevalence audit confirmed a postoperative pulmonary complication rate of 16/83 (19...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28052910/acupuncture-and-pc6-stimulation-for-the-prevention-of-postoperative-nausea-and-vomiting-in-patients-undergoing-elective-laparoscopic-resection-of-colorectal-cancer-a-study-protocol-for-a-three-arm-randomised-pilot-trial
#9
Kun Hyung Kim, Dae Hun Kim, Ji Min Bae, Gyung Mo Son, Kyung Hee Kim, Seung Pyo Hong, Gi Young Yang, Hee Young Kim
INTRODUCTION: This study aims to assess the feasibility of acupuncture and a Pericardium 6 (PC6) wristband as an add-on intervention of antiemetic medication for the prevention of postoperative nausea and vomiting (PONV) in patients undergoing elective laparoscopic colorectal cancer resection. METHODS AND ANALYSIS: A total of 60 participants who are scheduled to undergo elective laparoscopic resection of colorectal cancer will be recruited. An enhanced recovery after surgery protocol using standardised antiemetic medication will be provided for all participants...
January 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#10
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28010813/changes-in-systolic-arterial-pressure-variability-are-associated-with-the-decreased-aerobic-performance-of-rats-subjected-to-physical-exercise-in-the-heat
#11
Flávia C Müller-Ribeiro, Samuel P Wanner, Weslley H M Santos, Milene R Malheiros-Lima, Ivana A T Fonseca, Cândido C Coimbra, Washington Pires
Enhanced cardiovascular strain is one of the factors that explains degraded aerobic capacity in hot environments. The cardiovascular system is regulated by the autonomic nervous system, whose activity can be indirectly evaluated by analyzing heart rate variability (HRV) and systolic arterial pressure (SAP) variability. However, no study has addressed whether HRV or SAP variability can predict aerobic performance during a single bout of exercise. Therefore, this study aimed to investigate whether there is an association between cardiovascular variability and performance in rats subjected to treadmill running at two ambient temperatures...
January 2017: Journal of Thermal Biology
https://www.readbyqxmd.com/read/28009729/impact-of-enhanced-recovery-after-surgery-and-fast-track-surgery-pathways-on-healthcare-associated-infections-results-from-a-systematic-review-and-meta-analysis
#12
Michael C Grant, Dongjie Yang, Christopher L Wu, Martin A Makary, Elizabeth C Wick
OBJECTIVE: The aim of this study was to establish if enhanced recovery after surgery (ERAS) and fast track surgery (FTS) protocols are associated with reduction in healthcare-associated infection (HAIs). BACKGROUND: Evidence suggests that prevention strategies for HAIs should be multifaceted and transdisciplinary. ERAS and FTS protocols are collaborative approaches to perioperative care which reduce length of stay but may also be an effective strategy for reducing HAIs...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28009223/development-of-an-enhanced-recovery-after-surgery-eras-approach-for-lumbar-spinal-fusion
#13
Michael Y Wang, Peng-Yuan Chang, Jay Grossman
OBJECTIVE Over the past decade, Enhancing Recovery After Surgery (ERAS) programs have been implemented throughout the world across multiple surgical disciplines. However, to date no spinal surgery equivalent has been described. In this report the authors review the development and implementation of a "fast track" surgical approach for lumbar fusion. METHODS The first 42 consecutive cases in which patients were treated with the new surgical procedure were reviewed. A combination of endoscopic decompression, expandable cage deployment, and percutaneous screw placement were performed with liposomal bupivacaine anesthesia to allow the surgery to be performed without general endotracheal anesthesia...
December 23, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28003177/substitution-of-usual-perioperative-care-by-ehealth-to-enhance-postoperative-recovery-in-patients-undergoing-general-surgical-or-gynecological-procedures-study-protocol-of-a-randomized-controlled-trial
#14
Eva van der Meij, Judith Af Huirne, Esther Va Bouwsma, Johanna M van Dongen, Caroline B Terwee, Peter M van de Ven, Chantal M den Bakker, Suzan van der Meij, W Marchien van Baal, Wouter Kg Leclercq, Peggy Maj Geomini, Esther Cj Consten, Steven E Schraffordt Koops, Paul Jm van Kesteren, Hein Bac Stockmann, A Dorien Ten Cate, Paul Hp Davids, Petrus C Scholten, Baukje van den Heuvel, Frederieke G Schaafsma, Wilhelmus Jhj Meijerink, H Jaap Bonjer, Johannes R Anema
BACKGROUND: Due to the strong reduction in the length of hospital stays in the last decade, the period of in-hospital postoperative care is limited. After discharge from the hospital, guidance and monitoring on recovery and resumption of (work) activities are usually not provided. As a consequence, return to normal activities and work after surgery is hampered, leading to a lower quality of life and higher costs due to productivity loss and increased health care consumption. OBJECTIVE: With this study we aim to evaluate whether an eHealth care program can improve perioperative health care in patients undergoing commonly applied abdominal surgical procedures, leading to accelerated recovery and to a reduction in costs in comparison to usual care...
December 21, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/28002297/enhanced-recovery-pathways-for-improving-outcomes-after-minimally-invasive-gynecologic-oncology-surgery
#15
Dennis Goulet, Valery Danilack, Kristen A Matteson
No abstract text is available yet for this article.
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28002175/executive-summary-enhanced-recovery-after-surgery-best-practice-guideline-for-care-of-patients-with-a-fecal-diversion
#16
Debbie Miller, Emily Pearsall, Debra Johnston, Monica Frecea, Marg McKenzie
Enhanced Recovery After Surgery (ERAS) is a multimodal program developed to decrease postoperative complications, improve patient safety and satisfaction, and promote early discharge. In the province of Ontario, Canada, a standardized approach to the care of adult patients undergoing elective colorectal surgery (including benign and malignant diseases) was adopted by 15 hospitals in March 2013. All colorectal surgery patients with or without an ostomy were included in the ERAS program targeting a length of stay of 3 days for colon surgery and 4 days for rectal surgery...
December 19, 2016: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/27997472/ensuring-early-mobilization-within-an-enhanced-recovery-program-for-colorectal-surgery-a-randomized-controlled-trial
#17
Julio Flavio Fiore, Tanya Castelino, Nicolò Pecorelli, Petru Niculiseanu, Saba Balvardi, Olivia Hershorn, Sender Liberman, Patrick Charlebois, Barry Stein, Franco Carli, Nancy Mayo, Liane S Feldman
OBJECTIVE: To estimate the extent to which the addition of staff-directed facilitation of early mobilization to an Enhanced Recovery Program (ERP) impacts recovery after colorectal surgery, compared with usual care. SUMMARY BACKGROUND DATA: Early mobilization is considered an important component of ERPs but, despite guidelines recommendations, adherence remains quite low. The value of dedicating specific resources (eg, staff time) to increase early mobilization is unknown...
December 16, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27994918/use-of-systemic-rosmarinus-officinalis-to-enhance-the-survival-of-random-pattern-skin-flaps
#18
Bilsev İnce, Fatma Bilgen, Ayşe Özlem Gündeşlioğlu, Mehmet Dadacı, Sümeyye Kozacıoğlu
BACKGROUND: Skin flaps are commonly used in soft-tissue reconstruction; however, necrosis can be a frequent complication. Several systemic and local agents have been used in attempts to improve skin flap survival, but none that can prevent flap necrosis have been identified. AIMS: This study aims to determine whether the use of systemic Rosmarinus officinalis (R. officinalis) extract can prevent flap necrosis and improve skin flap recovery. STUDY DESIGN: Animal experimentation...
November 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27988869/comparative-pharmacology-and-guide-to-the-use-of-the-serotonin-5-ht3-receptor-antagonists-for-postoperative-nausea-and-vomiting
#19
Anthony L Kovac
Since the introduction of the serotonin 5-hydroxy tryptamine 3 (5-HT3) receptor antagonists in the early 1990s, the incidence of postoperative nausea and vomiting (PONV) and post-discharge nausea and vomiting (PDNV) has decreased, yet continues to be a problem for the surgical patient. The clinical application of the 5-HT3 receptor antagonists has helped define the approach and role of these antiemetics in the prevention and treatment of PONV and PDNV. Pharmacological and clinical differences exist among these medications resulting in corresponding differences in effectiveness, safety, optimal dosage, time of administration, and use as combination and rescue antiemetic therapy...
December 2016: Drugs
https://www.readbyqxmd.com/read/27986577/fast-track-bariatric-surgery-safety-of-discharge-on-the-first-postoperative-day-after-bariatric-surgery
#20
Zhamak Khorgami, Jacob A Petrosky, Amin Andalib, Ali Aminian, Philip R Schauer, Stacy A Brethauer
BACKGROUND: Fast track recovery pathways have resulted in a multidisciplinary approach to enhance postoperative recovery. OBJECTIVES: To assess feasibility and outcome of early discharge after laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). SETTING: The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to identify patients with body mass index≥35 kg/m(2) who underwent LSG or LRYGB in 2012 and 2013...
February 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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