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Enhanced recovery laparoscopic surgery

F Creamer, A Balfour, S Nimmo, I Foo, J D Norrie, L J Williams, K C Fearon, H M Paterson
BACKGROUND: Combined oral modified-release oxycodone-naloxone may reduce opioid-induced postoperative gut dysfunction. This study examined the feasibility of a randomized trial of oxycodone-naloxone within the context of enhanced recovery for laparoscopic colorectal resection. METHODS: In a single-centre open-label phase II feasibility study, patients received analgesia based on either oxycodone-naloxone or oxycodone. Primary endpoints were recruitment, retention and protocol compliance...
October 20, 2016: British Journal of Surgery
Jaime Ruiz-Tovar, Pablo Royo, José L Muñoz, Manuel Duran, Elisabeth Redondo, Jose M Ramirez
INTRODUCTION: The essence of Enhanced Recovery After Surgery (ERAS) programs is the multimodal approach, and many authors have demonstrated safety and feasibility in fast track bariatric surgery. According to this concept, a multidisciplinary ERAS program for bariatric surgery has been developed by the Spanish fast track group (ERAS Spain). The aim of this study was to analyze the initial implementation of this Spanish National ERAS protocol in bariatric surgery. PATIENTS AND METHODS: A multicentric prospective pilot study was performed, including 125 consecutive patients undergoing bariatric surgery at 3 Spanish hospitals between January and June 2015, after the Spanish National ERAS protocol in bariatric surgery...
October 7, 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
Hirofumi Ota, Masakazu Ikenaga, Junichi Hasegawa, Kohei Murata, Yasuhiro Miyake, Tsunekazu Mizushima, Taishi Hata, Ichiro Takemasa, Hirofumi Yamamoto, Mitsugu Sekimoto, Riichiro Nezu, Yuichiro Doki, Masaki Mori
PURPOSE: The aim of this multi-institutional study was to prospectively evaluate the safety and efficacy of an enhanced recovery after surgery (ERAS) protocol for colonic surgery. METHODS: The subjects of this study were 320 patients with an American Society of Anesthesiologists (ASA) grade I or II physical status. Patients underwent elective open or laparoscopic colonic resection or high anterior resection between April 2011 and January 2014 at one of six institutions...
September 29, 2016: Surgery Today
Fei Liu, Jingyi Zhang, Chuanfen Lei, Yonggang Wei, Bo Li
BACKGROUND: Though accumulated evidence proved that laparoscopic major hepatectomy was technically feasible, it remains a challenging procedure and is limited to highly specialized centers. Paragonimiasis is one of the most important food-borne parasitic zoonoses caused by the trematode of the genus Paragonimus. Although hepatic paragonimiasis is rare, the previous studies had investigated hepatic paragonimiasis from different perspectives. However, the safety and feasibility of laparoscopic major hepatectomy for hepatic paragonimiasis have not yet been reported in the literature...
September 2016: Medicine (Baltimore)
Xin-Xin Liu, Hua-Feng Pan, Zhi-Wei Jiang, Shu Zhang, Zhi-Ming Wang, Ping Chen, Yan Zhao, Gang Wang, Kun Zhao, Jie-Shou Li
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols or fast-track (FT) programs enable a shorter hospital stay and lower complication rate. Minimally invasive surgery (MIS) is associated with a lesser trauma and a quicker recovery in many elective abdominal surgeries. However, little is known of the safety and effectiveness made by ERAS protocols combined with MIS for gastric cancer. The purpose of this study was to evaluate the safety and effectiveness made by FT programs and MIS in combination or alone...
2016: Chinese Medical Journal
David E Messenger, Nathan J Curtis, Adam Jones, Emma L Jones, Neil J Smart, Nader K Francis
OBJECTIVE: To perform a systematic review of published literature for the factors reported to predict outcomes of enhanced recovery after surgery (ERAS) programmes following laparoscopic colorectal surgery. BACKGROUND: ERAS programmes and the use of laparoscopy have been widely adopted in colorectal surgery bringing short-term patient benefit. However, there is a minority of patients that do not benefit from these strategies and their identification is not well characterised...
September 8, 2016: Surgical Endoscopy
Phillippa Burnell, Rachael Coates, Steven Dixon, Lucy Grant, Matthew Grey, Ben Griffiths, Mike Jones, Anantha Madhavan, Iain McCallum, Ross McClean, Karen Naru, Lydia Newton, Paul O'Loughlin, Fadlo Shaban, Anisha Sukha, Sameer Somnath, Syed Shumon, Deena Harji
INTRODUCTION: Laparoscopic surgery combined with enhanced recovery programmes has become the gold standard in the elective management of colorectal disease. However, there is no consensus with regard to the optimal perioperative analgesic regime in this cohort of patients, with a number of options available, including thoracic epidural spinal analgesia, patient-controlled analgesia, subcutaneous and/or intraperitoneal local anaesthetics, local anaesthetic wound infiltration catheters and transversus abdominis plane blocks...
September 6, 2016: BMJ Open
Aparna Sinha, Lakshmi Jayaraman, Dinesh Punhani, Pradeep Chowbey
BACKGROUND: We discuss the anesthetic outcome in morbidly obese patients under the enhanced recovery after surgery (ERAS) protocol. Our evidence-based clinical pathways focused on prehabilitation and included interventions like aggressive preoperative optimization of medical comorbidities, familiarizing with perioperative protocols, thromboprophylaxis, opioid free multimodal analgesia, and early ambulation. METHODS: We did a retrospective analysis of prospectively collected data of 823 patients who underwent laparoscopic bariatric surgery...
September 6, 2016: Obesity Surgery
Delia Proposito, Francesca De Lucia, Alessandra Giannella, Francesca Frangella, Giuseppe Pappalardo, Maria Santangelo, Domenico Magagnano
AIM: Ganglioneuroma (GN) is the most uncommon and the most benign tumor among neuroblastic neoplasms, and in 29.7% of cases it finds in an adrenal gland. Usually asymptomatic, this tumor is detected incidentally in the majority of cases. It is generally challenging to obtain a precise diagnosis of adrenal ganglioneuroma (AGN) before surgery. Misdiagnosis rate of AGN on CT and MRI is 64.7% and clinicians and surgeons are often lacking in knowledge of this rare disease. For this reason, we pointed out the clinical, biochemical, radiologic and pathologic features of AGN in an our experience, with the aim to find out if there are some features able to facilitate a preoperative diagnosis...
2016: Annali Italiani di Chirurgia
W W Zhang, H G Wang, X J Shi, M Y Chen, S C Lu
OBJECTIVE: To discuss the significance of three-dimensional reconstruction as a method of preoperative planning of laparoscopic radiofrequency ablation(LRFA). METHODS: Thirty-two cases of LRFA admitted from January 2014 to December 2015 in Department of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital were analyzed(3D-LRFA group). Three-dimensional(3D) reconstruction were taken as a method of preoperative planning in 3D-LRFA group.Other 64 LRFA cases were paired over the same period without three-dimensional reconstruction before the operation (LRFA group)...
September 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
E Angenete, U Angerås, M Börjesson, J Ekelund, M Gellerstedt, T Thorsteinsdottir, G Steineck, E Haglind
BACKGROUND: Studies have reported that early physical rehabilitation after surgical procedures is associated with improved outcome measured as shorter hospital stay and enhanced recovery. The aim of this study was to explore the relationship between the preoperative physical activity level and subsequent postoperative complications, sick-leave and hospital stay after radical prostatectomy for prostate cancer in the setting of the LAPPRO trial (LAParoscopic Prostatectomy Robot Open). METHODS: LAPPRO is a prospective controlled trial, comparing robot-assisted laparoscopic and open surgery for localized prostate cancer between 2008 and 2011...
2016: BMC Urology
Gianluca Garulli, Andrea Lucchi, Pierluigi Berti, Carlo Gabbianelli, Luca Maria Siani
BACKGROUND: Enhanced Recovery After Surgery (E.R.A.S.) programs are now widely accepted in colonic laparoscopic resections because of faster recovery and less perioperative complications. The aim of this study was to assess safety and feasibility of discharging patients operated on by laparoscopic colectomy on postoperative day 2, so long as the first flatus has passed and in the absence of complication-related symptoms. METHODS: This study was a non-inferiority, open-label, single-center, prospective, randomized study comparing "Ultra" to Classic E...
August 12, 2016: Surgical Endoscopy
Henrik Torup, Egon G Hansen, Mikkel Bøgeskov, Jacob Rosenberg, Anja U Mitchell, Pernille L Petersen, Ole Mathiesen, Jørgen B Dahl, Ann M Møller
BACKGROUND: A key point in pathways for optimal rehabilitation and enhanced recovery is an effective postoperative multimodal pain treatment regimen. OBJECTIVE: To investigate the analgesic effects of transversus abdominis plane (TAP) block in conjunction with paracetamol and ibuprofen in patients undergoing laparoscopic colonic resection. DESIGN: Randomised placebo-controlled double-blind study. SETTING: Herlev University Hospital, Copenhagen, Denmark, from March 2010 to February 2013...
October 2016: European Journal of Anaesthesiology
Eric Marcotte, Bipan Chand
Bariatric surgery is well-recognized for its effects on health, beyond weight-loss. It underwent a revolution recently with the growing performance of laparoscopic procedures, leading to enhanced recovery and a reduction in procedural risk. However, surgical complications, although rare, do develop. It is important to recognize the complications, and ideally prevent them from happening. This article reviews the risks of the four most commonly performed bariatric procedures, with an emphasis on technique and management in the intraoperative and postoperative period...
August 2016: Surgical Clinics of North America
Emad Ali Ahmed, Roberto Montalti, Daniele Nicolini, Paolo Vincenzi, Martina Coletta, Andrea Vecchi, Federico Mocchegiani, Marco Vivarelli
BACKGROUND: FT program (FT) is a multimodal approach used to enhance postoperative rehabilitation and accelerate recovery. It was 1st described in open heart surgery, then modified and applied successfully in colorectal surgery. FT program was described in liver resection for the 1st time in 2008. Although the program has become widely accepted, it has not yet been considered the standard of care in liver surgery. OBJECTIVES: we performed this systematic review and meta-analysis to evaluate the impact of using the FT program compared to the traditional care (TC), on the main clinical and surgical outcomes for patients who underwent elective liver resection...
July 2016: Medicine (Baltimore)
Sae Byeol Choi, Sang Yong Choi
Recent advances in minimally invasive surgery include laparoscopic and robotic surgery. These surgical techniques have changed the paradigm of surgical treatment for hepatobiliary diseases. Minimally invasive surgery has the advantages of minimal wound extension for cosmetic effect, early postoperative recovery, and few postoperative complications in patients. For laparoscopic liver resection, the indications have been expanded and oncological outcome was proven to be similar with open surgery in the malignant disease...
June 2016: Kaohsiung Journal of Medical Sciences
Toshiaki Shichinohe, Takeshi Sasaki, Shuji Kitashiro, Takayuki Morita, Koichi Ono, Naoto Senmaru, Junichi Ikeda, Tetsufumi Kojima, Noriaki Kyogoku, Hidehisa Yamada, Nagato Sato, Kentaro Kato, Soichi Murakami, Yuma Ebihara, Yo Kurashima, Eiji Tamoto, Takehiro Noji, Toru Nakamura, Keisuke Okamura, Takahiro Tsuchikawa, Satoshi Hirano
PURPOSE: An amino acid-containing elemental diet (ED) does not require digestion for nutritional absorption, making it a good option for patients with gastrointestinal malabsorption. We conducted a randomized trial to confirm that perioperative ED enhanced the recovery of patients undergoing laparoscopic colectomy. METHODS: Patients in the intervention arm received commercially available ED from the day prior to surgery until postoperative day (POD) 3, whereas patients in the control group received a conventional perioperative diet program...
June 21, 2016: Surgery Today
Jocelyn S Chapman, Erika Roddy, Stefanie Ueda, Rebecca Brooks, Lee-Lynn Chen, Lee-May Chen
OBJECTIVE: To estimate whether an enhanced recovery after surgery pathway facilitates early recovery and discharge in gynecologic oncology patients undergoing minimally invasive surgery. METHODS: This was a retrospective case-control study. Consecutive gynecologic oncology patients undergoing laparoscopic or robotic surgery between July 1 and November 5, 2014, were treated on an enhanced recovery pathway. Enhanced recovery pathway components included patient education, multimodal analgesia, opioid minimization, nausea prophylaxis as well as early catheter removal, ambulation, and feeding...
July 2016: Obstetrics and Gynecology
H M Forsmo, F Pfeffer, A Rasdal, G Østgaard, A C Mohn, H Körner, C Erichsen
AIM: The aim of this randomized clinical trial was to compare patients treated using a multimodal approach [enhanced recovery after surgery (ERAS)], with a special focus on counselling, to patients treated in a standard conventional care pathway, who underwent elective colorectal resection. METHOD: In a single-centre trial, adult patients eligible for open or laparoscopic colorectal resection were randomized to an ERAS programme or standard care. The primary end-point was postoperative total hospital stay...
June 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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