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Enhanced recovery laparoscopic surgery

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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
#1
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/28059913/liposomal-bupivacaine-use-in-transversus-abdominis-plane-blocks-reduces-pain-and-postoperative-intravenous-opioid-requirement-after-colorectal-surgery
#2
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/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
#3
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
#4
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/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
#5
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/27997472/ensuring-early-mobilization-within-an-enhanced-recovery-program-for-colorectal-surgery-a-randomized-controlled-trial
#6
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/27986577/fast-track-bariatric-surgery-safety-of-discharge-on-the-first-postoperative-day-after-bariatric-surgery
#7
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
https://www.readbyqxmd.com/read/27978842/fast-track-surgery-after-gynaecological-oncological-surgery-study-protocol-for-a-prospective-randomised-controlled-trial
#8
Ling Cui, Yu Shi, G N Zhang
BACKGROUND: Fast-track surgery (FTS), also known as enhanced recovery after surgery, is a multidisciplinary approach to accelerate recovery, reduce complications, minimise hospital stay without increasing readmission rates, and reduce health care costs, all without compromising patient safety. The advantages of FTS in abdominal surgery most likely extend to gynaecological surgery, but this is an assumption, as FTS in elective gynaecological surgery has not been well studied. No consensus guidelines have been developed for gynaecological oncological surgery although surgeons have attempted to introduce slightly modified FTS programmes for patients undergoing such surgery...
December 15, 2016: Trials
https://www.readbyqxmd.com/read/27955884/pharmacogenetics-guided-analgesics-in-major-abdominal-surgery-further-benefits-within-an-enhanced-recovery-protocol
#9
Anthony J Senagore, Bradley J Champagne, Eslam Dosokey, Justin Brady, Scott R Steele, Harry L Reynolds, Sharon L Stein, Conor P Delaney
OBJECTIVE: Effective, narcotic sparing analgesia is a major component of Enhanced Recovery Protocols (ERP), however the risk of poor analgesia and opioid related side effects (ORADE) remains an issue related to poor outcomes and satisfaction, and is strongly related to the risk of narcotic dependence after surgery. A variety of genes can impact narcotic and non-steroidal (NSAID) drug efficacy including: the CYP family (drug metabolism-narcotics and NSAID), or COMT/ABCB1/OPRM1 (functional receptor and transport activity for analgesia vs side effects)...
November 22, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27943522/no-benefit-of-ultrasound-guided-transversus-abdominis-plane-tap-blocks-over-local-anaesthetic-wound-infiltration-in-elective-laparoscopic-colonic-surgery-results-of-a-double-blind-randomised-controlled-trial
#10
A Rashid, K J Gorissen, F Ris, M P Gosselink, J R Shorthouse, A D Smith, J J Pandit, I Lindsey, N Crabtree
AIM: Advances in laparoscopic techniques combined with enhanced recovery pathways have led to faster recuperation and discharge after colorectal surgery. Peripheral nerve blockade using Transversus Abdominis Plane (TAP) blocks reduce opioid requirements and provide better analgesia than inactive controls for laparoscopic colectomies. This double-blind randomized study was performed comparing TAP blocks using Bupivacaine to standardised wound infiltration with local anaesthetic (LA). METHODS: 71 Patients were randomised between either TAP-block or wound infiltration...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27926560/using-modified-frailty-index-to-predict-safe-discharge-within-48-hours-of-ileostomy-closure
#11
Yuxiang Wen, Murad A Jabir, Eslam M G Dosokey, Dongjin Choi, Clayton C Petro, Justin T Brady, Scott R Steele, Conor P Delaney
BACKGROUND: Enhanced recovery pathways allow for safe discharge and optimal outcomes within 48 hours after ileostomy closure. Unfortunately, some patients undergoing ileostomy closure have prolonged hospital stays. We have shown previously that the Modified Frailty Index can help predict patients who will fail early discharge after laparoscopic colorectal surgery. OBJECTIVE: The purpose of this study was to use the Modified Frailty Index to identify patients who were safe for early discharge after ileostomy closure...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27924202/randomized-trial-of-subfascial-infusion-of-ropivacaine-for-early-recovery-in-laparoscopic-colorectal-cancer-surgery
#12
Sang Hyun Lee, Woo-Seog Sim, Go Eun Kim, Hee Cheol Kim, Joo Hyun Jun, Jin Young Lee, Byung-Seop Shin, Heejin Yoo, Sin-Ho Jung, Joungyoun Kim, Seung Hyeon Lee, Deok Kyu Yo, Yu Ri Na
BACKGROUND: There is a need for investigating the analgesic method as part of early recovery after surgery tailored for laparoscopic colorectal cancer (LCRC) surgery. In this randomized trial, we aimed to investigate the analgesic efficacy of an inverse 'v' shaped bilateral, subfascial ropivacaine continuous infusion in LCRC surgery. METHODS: Forty two patients undergoing elective LCRC surgery were randomly allocated to one of two groups to receive either 0.5% ropivacaine continuous infusion at the subfascial plane (n = 20, R group) or fentanyl intravenous patient controlled analgesia (IV PCA) (n = 22, F group) for postoperative 72 hours...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27900463/a-model-for-lymphocyte-activation-in-open-versus-laparoscopic-surgery-in-colorectal-cancer-patients-in-enhanced-recovery-after-surgery-eras-protocols
#13
Ana Belén Martínez, J Longás, J M Ramírez
PURPOSE: Given the high mortality and morbidity associated with colon cancer worldwide and the advantages inherent to the use of the laparoscopy technique with respect to open surgery in oncological colorectal surgery, a study was designed to observe and compare the lymphocyte activation model between open surgery (OS) and laparoscopic surgery (LS) for this type of patient as part of an ERAS protocol. METHODS: A prospective study was conducted with 38 patients who underwent surgery due to colorectal disease and were included in an ERAS protocol...
November 30, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27875094/laparoscopic-radical-gastrectomy-for-resectable-advanced-gastric-cancer-within-enhanced-recovery-programs-a-prospective-randomized-controlled-trial
#14
Xia Mingjie, Zhang Luyao, Tang Ze, Zhao YinQuan, Wang Quan
BACKGROUND: Enhanced recovery programs have become an important focus of perioperative management. A few studies have demonstrated the efficacy of an enhanced recovery after surgery (ERAS, which includes optimized pain control, restricted I.V. fluids, early initiation of postoperative oral feeding, and enforced mobilization) protocol in patients undergoing radical gastrectomy. We investigated the feasibility and safety of laparoscopic radical gastrectomy within ERAS programs. METHODS: In this single-center prospective randomized controlled trial conducted between September 2013 and August 2014, 149 consecutive locally advanced gastric cancer patients (T2-4, any N, M0) diagnosed by the CT scanning were allocated to either ERAS group (N = 73) or conventional pathway group (N = 76)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27862828/introduction-of-robot-assisted-radical-cystectomy-within-an-established-enhanced-recovery-programme
#15
Catherine Miller, Nicholas J Campain, Rachel Dbeis, Mark Daugherty, Nicholas Batchelor, Elizabeth Waine, John S McGrath
OBJECTIVES: To describe the implementation phase of a robot-assisted radical cystectomy (RARC) programme including side-effect profiles and impact on length of stay (LOS). PATIENTS AND METHODS: In all, 114 consecutive patients (82% male) underwent RARC and urinary diversion between April 2013 and December 2015 [ileal conduit (97 patients) and orthotopic neobladder (17)]. Surgery was performed by two surgeons within a designated regional cancer centre. No exclusion criteria were applied...
November 15, 2016: BJU International
https://www.readbyqxmd.com/read/27828724/minimally-invasive-distal-pancreatectomy-review-of-the-english-literature
#16
Kai Wang, Ying Fan
BACKGROUND: Recently, the superiority of the minimally invasive approach, which results in a better cosmetic result, faster recovery, and shorter length of hospital stay, is a technique that has been progressively recognized as it has developed. And the minimally invasive approach has been applied to distal pancreatectomy (DP), which is a standard method for the treatment of benign, borderline, and part of malignant lesions of the pancreatic body and tail. This article aims to analyze the types, postoperative recovery, and outcomes of laparoscopic distal pancreatectomy (LDP)...
November 9, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27783027/eras-protocol-reduces-il-6-secretion-in-colorectal-laparoscopic-surgery-results-from-a-randomized-clinical-trial
#17
Giulio Mari, Jacopo Crippa, Andrea Costanzi, Michele Mazzola, Michele Rossi, Dario Maggioni
BACKGROUND: Enhanced Recovery After Surgery (ERAS) program applied to colorectal laparoscopic surgery is well known to reduce hospitalization improving short-terms outcomes. Its goal is to minimize the surgical stress response in order to maintain the physiological homeostasis altered by surgery. However, there is little knowledge about the involved dynamics in the reduction of the surgical stress that these programs allow. The primary aim of this study was to compare the level of immune and nutritional serum investigators across surgery in patients undergoing elective colorectal laparoscopic surgery within an ERAS protocol or according to a standard care program...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27783025/early-discharge-after-colorectal-resection-the-positive-impact-of-an-enhanced-recovery-program-on-a-rural-colorectal-surgery-service
#18
Giovanni D Tebala, Sean Keane, Abdelsalam Osman, Mina Ip, Abdul Q Khan, Luciano Perrone
BACKGROUND: Enhanced recovery (ER) programs are policies and protocols meant to improve postoperative recovery after surgery. As a consequence of a smoother recovery, patients can be discharged early. This paper describes the impact of an ER program in colorectal surgery in a rural hospital. MATERIALS AND METHODS: In total, 132 patients had colorectal resection within the ER program. Data were collected prospectively. The ER pathway affects perioperative management in the following ways in order to: (1) improve patient's general condition before surgery, (2) minimize intraoperative surgical trauma by using a laparoscopic approach in all cases, and (3) facilitation of a quicker postoperative return of physiological function...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27780772/pre-and-postoperative-stoma-education-and-guidance-within-an-enhanced-recovery-after-surgery-eras-programme-reduces-length-of-hospital-stay-in-colorectal-surgery
#19
H M Forsmo, F Pfeffer, A Rasdal, H Sintonen, H Körner, C Erichsen
INTRODUCTION: Stoma formation delays discharge after colorectal surgery. Stoma education is widely recommended, but little data are available regarding whether educational interventions are effective. The aim of this prospective study was to investigate whether an enhanced recovery after surgery (ERAS) programme with dedicated ERAS and stoma nurse specialists focusing on counselling and stoma education can reduce the length of hospital stay, re-admission, and stoma-related complications and improve health-related quality of life (HRQoL) compared to current stoma education in a traditional standard care pathway...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27762434/randomized-open-label-phase-ii-study-comparing-oxycodone-naloxone-with-oxycodone-in-early-return-of-gastrointestinal-function-after-laparoscopic-colorectal-surgery
#20
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...
January 2017: British Journal of Surgery
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