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Enhanced recovery laparoscopic surgery

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https://www.readbyqxmd.com/read/28516129/enhanced-recovery-after-colorectal-surgery-eras-in-elderly-patients-is-feasible-and-achieves-similar-results-as-in-younger-patients
#1
Håvard Mjørud Forsmo, Christian Erichsen, Anne Rasdal, Hartwig Körner, Frank Pfeffer
Aim: Enhanced recovery after surgery (ERAS) is a multimodal approach that aims to optimize perioperative treatment. Whether elderly patients receiving colorectal surgery can adhere to and benefit from an ERAS approach is uncertain. The aim of this study was to compare patients in different age groups participating in an ERAS program. Method: In this substudy of a randomized controlled trial, we analyzed the interventional ERAS arm of adult patients eligible for laparoscopic or open colorectal resection with regard to the importance of age...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28459732/goal-directed-fluid-therapy-does-not-reduce-primary-postoperative-ileus-after-elective-laparoscopic-colorectal-surgery-a-randomized-controlled-trial
#2
Juan C Gómez-Izquierdo, Alessandro Trainito, David Mirzakandov, Barry L Stein, Sender Liberman, Patrick Charlebois, Nicolò Pecorelli, Liane S Feldman, Franco Carli, Gabriele Baldini
BACKGROUND: Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. METHODS: Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program...
May 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28457337/c-reactive-protein-as-early-predictor-of-complications-after-minimally-invasive-colorectal-resection
#3
Corrado Pedrazzani, Margherita Moro, Guido Mantovani, Enrico Lazzarini, Simone Conci, Andrea Ruzzenente, Giuseppe Lippi, Alfredo Guglielmi
BACKGROUND: Minimally invasive surgery (MIS) and enhanced recovery programs have been increasingly adopted in colorectal surgery. The aim of this prospective observational study was to evaluate the usefulness of the C-reactive protein (CRP) concentration measured on postoperative day 3 (POD-3) as an early predictor of severe complications after minimally invasive colorectal resection. MATERIALS AND METHODS: From January 2014 to December 2015, 160 patients underwent resection of colorectal disease by MIS at the Division of General and Hepatobiliary Surgery, University of Verona Hospital Trust...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28455803/experience-with-an-enhanced-recovery-after-surgery-eras-program-for-bariatric-surgery-comparison-of-mgb-and-lsg-in-374-patients
#4
Marie-Cécile Blanchet, Benoît Gignoux, Yann Matussière, Alexandre Vulliez, Thomas Lanz, Fabienne Monier, Vincent Frering
BACKGROUND: Strategic multidisciplinary protocols for "enhanced recovery after surgery" (ERAS) have demonstrated reductions in length of hospital stay (LOS), morbidity, and costs in conjunction with bariatric procedures. METHODS: We prospectively investigated the effectiveness and safety of an ERAS protocol with laparoscopic omega loop gastric bypass ("mini" gastric bypass, MGB) and LSG in morbidly obese patients. RESULTS: Average LOS was 1...
April 28, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28414709/robotic-surgery-fast-forward-to-telemedicine
#5
George B Stefano
Since the realization that certain maladies can be corrected via surgical techniques, we have been consumed by the desire to constantly advance the tools of surgery, as well as the techniques. In recent times, computer-assisted surgical tools have emerged and are growing in their use. The Puma 560 emerged in 1985 for brain biopsies and laparoscopic surgery. Prostatic surgery was performed by the Probot in 1988. In 1992, fittings in the femur were placed using the ROBODOC. These early robotic endeavors gave rise to AESOP, ZEUS and the relatively intuitive da Vinci® Surgical System...
April 17, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28389089/how-can-recovery-be-enhanced-after-single-stage-laparoscopic-management-of-cbd-stones-endoscopic-treatment-versus-laparoscopic-surgery
#6
Emilie Chapuis-Roux, Laurent Pellissier, Francois Browet, Jean Charles Berthou, Sami Hakim, Franck Brazier, Cyril Cosse, Richard Delcenserie, Jean Marc Regimbeau
BACKGROUND: Single-stage management of CBD stones comprises simultaneous common bile duct (CBD) clearance and cholecystectomy. The CBD can be cleared by using endoscopic treatment (ET) or laparoscopic surgery (LS) alone. AIMS: To determine the most rapid recovery after the single-stage laparoscopic management of CBD stones. METHODS: Patients with CBD stones treated at either of two centers (one performing ET only and one performing LS only for single-stage treatment) were included...
March 22, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28378083/minor-laparoscopic-liver-resection-toward-1-day-surgery
#7
Nicola de'Angelis, Benjamin Menahem, Philippe Compagnon, Jean Claude Merle, Francesco Brunetti, Alain Luciani, Daniel Cherqui, Alexis Laurent
BACKGROUND: Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). METHODS: The study sample consisted of patients with both benign and malignant hepatic lesions involving no more than two hepatic segments who underwent minor LLR and were discharged within 24 h...
April 4, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28332129/development-of-an-enhanced-recovery-after-surgery-eras-protocol-in-laparoscopic-colorectal-surgery-results-of-the-first-120-consecutive-cases-from-a-university-hospital
#8
Antonio Brescia, Federico Tomassini, Giammauro Berardi, Carola Sebastiani, Massimo Pezzatini, Anna Dall'Oglio, Giovanni Guglielmo Laracca, Fabrizio Apponi, Marcello Gasparrini
The ERAS(®) represents a dynamic culmination of upon perioperative care elements, successfully applied to different surgical specialties with shorter hospital stay and lower morbidity rates. The aim of this study is to describe the introduction of the ERAS protocol in colorectal surgery in our hospital analysing our first series. Between September 2014 and June 2016, 120 patients suffering from colorectal diseases were included in the study. Laparoscopic approach was used in all patients if not contraindicated...
March 22, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28331173/laparoscopic-gastrectomy-with-enhanced-recovery-after-surgery-protocol-single-center-experience
#9
Magdalena Pisarska, Michał Pędziwiatr, Piotr Major, Michał Kisielewski, Marcin Migaczewski, Mateusz Rubinkiewicz, Piotr Budzyński, Krzysztof Przęczek, Anna Zub-Pokrowiecka, Andrzej Budzyński
BACKGROUND Surgery remains the mainstay of gastric cancer treatment. It is, however, associated with a relatively high risk of perioperative complications. The use of laparoscopy and the Enhanced Recovery After Surgery (ERAS) protocol allows clinicians to limit surgically induced trauma, thus improving recovery and reducing the number of complications. The aim of the study is to present clinical outcomes of patients with gastric cancer undergoing laparoscopic gastrectomy combined with the ERAS protocol. MATERIAL AND METHODS Fifty-three (21 female/32 male) patients who underwent elective laparoscopic total gastrectomy due to cancer were prospectively analyzed...
March 23, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28314303/enhanced-recovery-after-surgery-programs-for-laparoscopic-colorectal-resection-may-not-need-thoracic-epidural-analgesia
#10
Ken Eto, Ichiro Kondo, Makoto Kosuge, Masahisa Ohkuma, Koichiro Haruki, Kai Neki, Hiroshi Sugano, Ryosuke Hashizume, Katsuhiko Yanaga
BACKGROUND/AIM: The aim of this study was to evaluate the necessity of thoracic epidural analgesia (TEA) as enhanced recovery after surgery (ERAS) programs for laparoscopic colorectal surgery (LC). PATIENTS AND METHODS: We retrospectively compared between perioperative outcomes of patients who underwent LC with TEA (n=31) and with multimodal analgesia (MMA) (n=31). Furthermore, we also evaluated the patients' satisfaction by a questionnaire survey to the nurses...
March 2017: Anticancer Research
https://www.readbyqxmd.com/read/28303874/-radical-oncological-stomach-liver-and-pancreatic-surgery-in-patients-over-80-years-old
#11
V K Lyadov, I A Kozyrin, Z A Kovalenko
AIM: To analyze the results of radical surgery for upper GI cancer in patients ≥80 years old. MATERIAL AND METHODS: For the period November 2010 - June 2015 there were 14 radical operations in elderly (≥80 years) patients with gastric, liver and pancreatic tumors. There were 4 Whipple procedures, 4 total and 2 distal gastrectomies, 1 total pancreatectomy as well as a central liver resection, one laparoscopic 5 segment resection and one 2, 3, 7 segment resection...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28289972/impact-of-laparoscopy-on-adherence-to-an-enhanced-recovery-pathway-and-readiness-for-discharge-in-elective-colorectal-surgery-results-from-the-perioperative-italian-society-registry
#12
Marco Braga, Felice Borghi, Marco Scatizzi, Giancarlo Missana, Marco Azzola Guicciardi, Stefano Bona, Ferdinando Ficari, Marianna Maspero, Nicolò Pecorelli
INTRODUCTION: Previous studies reported that laparoscopic surgery (LPS) improved postoperative outcomes in patients undergoing colorectal surgery within an enhanced recovery program (ERP). However, the effect of minimally invasive surgery on each ERP item has not been clarified, yet. The aim of this study is to assess the impact of LPS on adherence to ERP items and recovery as measured by time to readiness for discharge (TRD). METHODS: Prospectively collected data entered in an electronic Italian registry specifically designed for ERP were reviewed...
March 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28277883/prucalopride-for-the-treatment-of-ileus
#13
REVIEW
Christopher J Smart, Kamran I Malik
Postoperative ileus (POI) is an impairment of coordinated gastrointestinal (GI) motility that develops as a consequence of abdominal surgery and is a major factor contributing to patient morbidity and prolonged hospitalisation. Despite the availability of various options its treatment is still under debate. This review will focus on effect of Prucalopride (5-HT4 receptor agonist) on postoperative ileus based on the existing literature. Areas covered: A literature search of MEDLINE, EMBASE and COCHRANE Library was performed concerning topics related to the treatment of ileus with prucalopride...
April 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28260688/suturing-method-as-a-factor-for-uterine-vascularity-after-laparoscopic-myomectomy
#14
Akihisa Fujimoto, Chieko Morimoto, Yumi Hosokawa, Akiko Hasegawa
OBJECTIVE: To evaluate the vascularity of the myometrium after laparoscopic myomectomy sutured by two different methods using contrast-enhanced Magnetic Resonance Imaging. STUDY DESIGN: Twenty-eight women who had symptomatic leiomyomas and underwent laparoscopic myomectomy between June 2013 and July 2014 were included in the present study. In the first half period, continuous sutures were used in 12 patients, and in the latter half period, single interrupted sutures were used in 16 patients...
April 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28259181/effectiveness-of-deep-versus-moderate-muscle-relaxation-during-laparoscopic-donor-nephrectomy-in-enhancing-postoperative-recovery-study-protocol-for-a-randomized-controlled-study
#15
Moira H D Bruintjes, Andries E Braat, Albert Dahan, Gert-Jan Scheffer, Luuk B Hilbrands, Frank C H d'Ancona, Rogier A R T Donders, Cornelis J H M van Laarhoven, Michiel C Warlé
BACKGROUND: Postoperative recovery after live donor nephrectomy is largely determined by the consequences of postoperative pain and analgesia consumptions. The use of deep neuromuscular blockade has been shown to reduce postoperative pain scores after laparoscopic surgery. In this study, we will investigate whether deep neuromuscular blockade also improves the early quality of recovery after live donor nephrectomy. METHODS: The RELAX-study is a phase IV, multicenter, double-blinded, randomized controlled trial, in which 96 patients, scheduled for living donor nephrectomy, will be randomized into two groups: one with deep and one with moderate neuromuscular blockade...
March 4, 2017: Trials
https://www.readbyqxmd.com/read/28235668/analysis-of-delayed-discharge-after-day-surgery-laparoscopic-cholecystectomy
#16
Junning Cao, Bo Liu, Xiangjun Li, Jianjun Leng, Xiangfei Meng, Yingwei Pan, Songmeng Dou, Shichun Lu
BACKGROUND: Delayed discharge is the existing obstacle to further enhancing quality of recovery after Day-surgery laparoscopic cholecystectomy (LC/DS). This study aims to analyze the reasons for delayed discharge after LC/DS. METHODS: The 745 patients with delayed discharge after LC/DS were retrospectively studied. The reasons for delayed discharge and data related to patients were collected and analyzed. Psychosocial reasons were defined by meeting discharge criteria but refusing to discharge, and complications were defined and graded using the "Clavien-Dindo" classification system...
April 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28222805/use-of-activity-tracking-in-major-visceral-surgery-the-enhanced-perioperative-mobilization-epm-trial-study-protocol-for-a-randomized-controlled-trial
#17
Steffen Wolk, Theresa Meißner, Sebastian Linke, Benjamin Müssle, Ann Wierick, Andreas Bogner, Dorothée Sturm, Nuh N Rahbari, Marius Distler, Jürgen Weitz, Thilo Welsch
BACKGROUND: Enhanced recovery after surgery (ERAS) programs are aimed at minimizing postoperative stress and accelerating postoperative recovery by implementing multiple perioperative principles. "Early mobilization" is one such principle, but the quality of assessment and monitoring is poor, and evidence of improved outcome is lacking. Activity trackers allow precise monitoring and automatic feedback to the patients to enhance their motivation for early mobilization. The aim of the study is to monitor and increase the postoperative mobilization of patients by giving them continuous automatic feedback in the form of a step count using activity-tracking wristbands...
February 21, 2017: Trials
https://www.readbyqxmd.com/read/28222423/introduction-of-an-enhanced-recovery-after-surgery-protocol-for-robot-assisted-laparoscopic-radical-prostatectomy
#18
Motohiko Sugi, Tadashi Matsuda, Takashi Yoshida, Hisanori Taniguchi, Takao Mishima, Masaaki Yanishi, Yoshihiro Komai, Kaneki Yasuda, Hidefumi Kinoshita, Kenji Yoshida, Masato Watanabe
INTRODUCTION: No studies have shown whether the enhanced recovery after surgery (ERAS) protocol is superior to the conventional protocol after robot-assisted laparoscopic radical prostatectomy (RALP). We compared intestinal function and perioperative parameters of patients with prostate cancer after the ERAS and conventional protocols to determine the superior protocol for recovery of intestinal function. MATERIAL AND METHODS: A retrospective analysis of 198 consecutive patients who underwent RALP between August 2013 and June 2015 was conducted...
February 17, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28167964/safety-and-cost-considerations-during-the-introduction-period-of-laparoscopic-radical-hysterectomy
#19
A Anagnostopoulos, S Mitra, B Decruze, R Macdonald, J Kirwan
Objective. To compare the safety, efficacy, and direct cost during the introduction of laparoscopic radical hysterectomy within an enhanced recovery pathway. Methods. A 1 : 1 single centre retrospective case control study of 36 propensity matched pairs of patients receiving open or laparoscopic surgery for early cervical cancer. Results. There were no significant differences in the baseline characteristics of the two cohorts. Open surgery cohort had significantly higher intraoperative blood loss (189 versus 934 mL) and longer postoperative hospital stay (2...
2017: Obstetrics and Gynecology International
https://www.readbyqxmd.com/read/28162161/-effect-of-dexmedetomidine-alone-for-postoperative-analgesia-after-laparoscopic-cholecystectomy
#20
X H Chen, Z J Wang, Q M Xiang, J W Zheng
Objective: To investigate the effect of dexmedetomidine alone for postoperative analgesia after laparoscopic cholecystectomy. Methods: Forty patients scheduled for elective laparoscopic cholecystectomy in First Hospital of Ninghai County, American Society of Anesthesiologists (ASA) gradeⅠor Ⅱ, were randomly divided into dexmedetomidine group (Group D, n=20) and fentanyl group (Group F, n=20). The patient controlled analgesia (PCA) pumps were used after the operation. In the group D, the intravenous PCA protocol was dexmedetomidine 0...
January 24, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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