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Enhanced recovery laparoscopic surgery

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https://www.readbyqxmd.com/read/29023334/application-of-enhanced-recovery-after-surgery-in-single-incision-laparoscopic-distal-gastrectomy
#1
Junfeng Zhou, Qingliang He, Jiaxing Wang, Qicai Liu, Mi Wang
BACKGROUND: Recently, enhanced recovery after surgery (ERAS) was widely used in the perioperative management of gastric cancer. The study aimed to evaluate the safety and effectiveness of ERAS in single-incision laparoscopic distal gastrectomy (SIDG). MATERIALS AND METHODS: A total of 90 patients who received laparoscopic gastric cancer resection were divided into 3 groups: group A (n=30), underwent traditional multiport laparoscopic distal gastrectomy with conventional perioperative management; group B (n=30) underwent traditional multiport laparoscopic distal gastrectomy with ERAS concept; and group C (n=30), underwent SIDG with ERAS concept...
October 11, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29022790/accelerated-discharge-within-72-hours-of-colorectal-cancer-resection-using-simple-discharge-criteria
#2
A Emmanuel, E Chohda, C Botfield, J Ellul
Introduction Short hospital stays and accelerated discharge within 72 hours following colorectal cancer resections have not been widely achieved. Series reporting on accelerated discharge involve heterogeneous patient populations and exclude important groups. Strict adherence to some discharge requirements may lead to delays in discharge. The aim of this study was to evaluate the safety and feasibility of accelerated discharge within 72 hours of all elective colorectal cancer resections using simple discharge criteria...
September 15, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28976345/-impact-of-a-goal-directed-therapy-in-the-implementation-of-an-eras-enhanced-recovery-after-surgery-protocol-in-laparoscopic-radical-cystectomy
#3
Rafael Uña Orejón, Ivan Huercio Martinez, Estrella Mateo Torres, Cristina Jofré Escudero, Juan Gomez Rivas, Jesús Diez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVES: The intraoperative goaldirected fluid therapy (GDT) has become the base of perioperative management in the fast-track protocols. This program using technology to estimate cardiac output, with the aim of minimizing splanchnic hypoperfusion. However, there is insufficient evidence to confirm its application in radical laparoscopic cystectomy. METHODS: In a retrospective study, we have included 52 patients that were scheduled for radical cystectomy. In group A (n=32) patients were treated following GDT...
October 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28964926/managing-postoperative-pain-after-minimally-invasive-gynecologic-surgery-in-the-era-of-the-opioid-epidemic
#4
REVIEW
Marron Wong, Stephanie Morris, Karen Wang, Khara Simpson
In this review, we examine the evidence behind non-opioid medication alternatives, peripheral nerve blocks, surgical techniques, and postoperative recovery protocols that can help minimize and effectively treat postoperative pain after minimally invasive gynecologic surgery (MIGS). Due to the depth and heterogeneity of the data, a narrative review was performed of reported interventions. A comprehensive review was performed of Pubmed, EMBASE, and the Cochrane Database with a focus on randomized controlled trials (RCT)...
September 27, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28951373/-enhanced-recovery-after-preserving-the-left-colonic-artery-during-laparoscopic-anterior-resection-for-rectal-cancer
#5
Yun-Geng Liu, Lei Zhang, Ji-Ran Huang, Jin-Rong Yi, Chuan-Fa Fang, Lai-Yang Xia, Hong-Quan Liu, Jian-Zhong Yi
OBJECTIVE: To evaluate the postoperative outcomes of preserving the left colonic artery during laparoscopic anterior resection for rectal cancer. METHODS: The clinicopathologic data of 91 rectal cancer patients (pathologic Stage II) undergoing laparoscopic anterior resection was retrospectively analyzed. During the surgeries, the left colonic artery was preserved in 40 patients (preserved group) and ligated in 51 patients (unpreserved group). The operating time, intraoperative blood loss, time to first flatus and defecation, duration of postoperative abdominal distension and pain, number of retrieved lymph nodes, ileum fistulation and anatomical leakage rate were compared between the two groups...
September 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28923225/randomized-clinical-trials-in-colon-and-rectal-cancer
#6
REVIEW
Atif Iqbal, Thomas J George
Surgery remains the mainstay of treatment for colon and rectal cancers. Colon cancer outcomes have improved with laparoscopic techniques, enhanced recovery pathways, and adjuvant chemotherapy. Adjuvant 5-fluorouracil with or without oxaliplatin in stage III and possibly high-risk stage II colon cancer is associated with improved survival. Multimodality management of rectal cancer continues to evolve; total mesorectal excision is the cornerstone. Oncologic results do not support the use of laparoscopic resection in rectal cancer...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28916861/predictors-of-adherence-to-enhanced-recovery-pathway-elements-after-laparoscopic-colorectal-surgery
#7
Juan Mata, Julio F Fiore, Nicolo Pecorelli, Barry L Stein, Sender Liberman, Patrick Charlebois, Liane S Feldman
INTRODUCTION: Enhanced recovery pathways (ERP) include a bundle of evidence-based preoperative, intraoperative, and postoperative interventions that together reduce morbidity and length of stay after colorectal surgery. Increased adherence with the bundle is associated with better postoperative outcomes, but adherence is lowest in the postoperative period. Identifying risk factors for lower adherence may help design quality improvement strategies. The aim of this study was to estimate the extent to which patient, procedural, and organizational factors predict adherence to postoperative ERP elements in laparoscopic colorectal surgery...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28893633/enhanced-recovery-open-versus-laparoscopic-left-donor-nephrectomy-a-randomized-controlled-trial
#8
Ahmed M Mansour, Ahmed R El-Nahas, Bedeir Ali-El-Dein, Ahmed Abdelfattah, Ahmed Hamed, Ahmed Abdel-Rahman, Ibrahim Eraky, Ahmed A Shokeir
OBJECTIVE: To compare recovery outcomes between laparoscopic donor nephrectomy (LDN) and open donor nephrectomy (ODN) within a specified Enhanced Recovery Program (ERP) for left kidney donations. MATERIALS AND METHODS: A phase III randomized trial was conducted between January 2013 and June 2015, eligible left side donors were randomized to laparoscopic or open donor nephrectomy in a 1:1 ratio with recovery optimized within a standardized ERP. The primary outcome was patient-reported measure of physical fatigue, as measured by the physical fatigue domain of the translated Multidimensional Fatigue Inventory 20 (MFI-20)...
September 8, 2017: Urology
https://www.readbyqxmd.com/read/28882327/erectile-function-and-oncologic-outcomes-following-open-retropubic-and-robot-assisted-radical-prostatectomy-results-from-the-laparoscopic-prostatectomy-robot-open-trial
#9
Prasanna Sooriakumaran, Giovanni Pini, Tommy Nyberg, Maryam Derogar, Stefan Carlsson, Johan Stranne, Anders Bjartell, Jonas Hugosson, Gunnar Steineck, Peter N Wiklund
BACKGROUND: Whether surgeons perform better utilising a robot-assisted laparoscopic technique compared with an open approach during prostate cancer surgery is debatable. OBJECTIVE: To report erectile function and early oncologic outcomes for both surgical modalities, stratified by prostate cancer risk grouping. DESIGN, SETTING, AND PARTICIPANTS: In a prospective nonrandomised trial, we recruited 2545 men with prostate cancer from seven open (n=753) and seven robot-assisted (n=1792) Swedish centres (2008-2011)...
September 4, 2017: European Urology
https://www.readbyqxmd.com/read/28881707/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#10
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
August 1, 2017: Oncotarget
https://www.readbyqxmd.com/read/28836243/-how-to-standardize-transanal-total-mesorectum-excision
#11
Liang Kang
Transanal total mesorectum excision (taTME) is a novel approach to treat rectal cancer by colorectal surgeons. How to standardize taTME is important for colorectal surgeons, especially at their initial attempt. They can start this approach cautiously only after they master skilled laparoscopic technique and pelvic anatomy, get the knowledge of taTME clearly, and are approved by healthcare department. The female patients with age <70 years old, distance of 5 to 7 cm from tumor inferior margin to anal verge, tumor size <3 cm, cTNM stage <T3aN0 are suitable for taTME...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28829221/enhanced-recovery-after-surgery-in-laparoscopic-surgery
#12
Kay B Leissner, Jessica L Shanahan, Peter L Bekker, Houman Amirfarzan
BACKGROUND: As part of an effort to maximize value in the perioperative setting, a paradigm shift is underway in the way that patients are cared for preoperatively, on the day of surgery, and postoperatively-a setting collectively known as the perioperative care. Enhanced Recovery After Surgery (ERAS(®)) is an evidence-based, patient-centered team approach to delivering high-quality perioperative care to surgical patients. METHODS: This review focuses on anesthesiologists, with their unique purview of perioperative setting, who are important drivers of change in the delivery of valuable perioperative care...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28815066/anaesthesia-during-oesophagectomy
#13
REVIEW
Denise P Veelo, Bart F Geerts
In this review, we will provide an overview of the current state of the art of perioperative practices for open and laparoscopic oesophagus surgery from the anaesthetist's perspective. Morbidity and mortality after oesophagectomy is still high despite multidisciplinary and enhanced recovery pathways showing promising results. The anaesthetist has an important role in the complex care of the oesophageal cancer patient. Minimizing unnecessary fluid administration, adequate pain management, hypotension, and protective lung ventilation are examples of proven strategies that can improve outcome after this high-risk surgery...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28767578/enhanced-recovery-after-surgery-program-reduces-length-of-hospital-stay-and-complications-in-liver-resection-a-prisma-compliant-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#14
REVIEW
Yiyang Zhao, Han Qin, Yang Wu, Bo Xiang
BACKGROUND: Many enhanced recovery after surgery (ERAS) guidelines have already been established in several kinds of surgeries. But due to concerns of the specific complications, it has not yet been considered the standard of care in liver surgery. OBJECTIVE: The aim of this review is to assess the effect of ERAS in patients undergoing liver surgery. METHODS: EMBASE, CNKI, PubMed, and the Cochrane Database were searched for randomized controlled trials (RCTs) comparing ERAS with conventional care in patients undergoing liver surgery...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28762024/risk-factors-for-prolonged-length-of-hospital-stay-and-readmissions-after-laparoscopic-sleeve-gastrectomy-and-laparoscopic-roux-en-y-gastric-bypass
#15
Piotr Major, Michał Wysocki, Grzegorz Torbicz, Natalia Gajewska, Alicja Dudek, Piotr Małczak, Michał Pędziwiatr, Magdalena Pisarska, Dorota Radkowiak, Andrzej Budzyński
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LRYGB) are most commonly performed bariatric procedures. Laparoscopic approach and enhanced recovery after surgery (ERAS) protocols managed to decrease length of hospital and morbidity. However, there are patients in whom, despite adherence to the protocol, the length of stay (LOS) remains longer than targeted. This study aimed to assess potential risk factors for prolonged LOS and readmissions. METHODS: The study was a prospective observation with a post-hoc analysis of bariatric patients in a tertiary referral university teaching hospital...
July 31, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28761868/standardizing-the-protocols-for-enhanced-recovery-from-colorectal-cancer-surgery-are-we-a-step-closer-to-ideal-recovery
#16
Mosab Shetiwy, Tamer Fady, Fayez Shahatto, Ahmed Setit
PURPOSE: Enhanced recovery protocols are being implemented into the standard of care in surgical practice. This study aimed to insert a steadfast set of elements into the perioperative care pathway to establish an improved recovery program for colorectal cancer patients. METHODS: Seventy patients planned for elective laparoscopic colorectal resection were randomized into 2 groups: conventional recovery group (n = 35) and enhanced recovery group (n = 35). The primary outcome was the length of hospital stay...
June 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28742435/the-role-of-transversus-abdominis-plane-blocks-in-enhanced-recovery-after-surgery-pathways-for-open-and-laparoscopic-colorectal-surgery
#17
Alexander J Kim, Robert Jason Yong, Richard D Urman
INTRODUCTION: The concepts of Enhanced Recovery After Surgery (ERAS(®)) have steadily increased in usage, with benefits in patient outcomes and hospital length of stay. One important component of successful implementation of ERAS protocol is optimized pain control, via the multimodal approach, which includes neuraxial or regional anesthesia techniques and reduction of opioid use as the primary analgesic. Transversus abdominis plane (TAP) block is one such regional anesthesia technique, and it has been widely studied in abdominal surgery...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742434/use-of-regional-anesthesia-techniques-analysis-of-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery
#18
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Principles of Enhanced Recovery After Surgery (ERAS(®)) protocols are well established, with the primary goal of optimizing perioperative care and recovery. The use of multimodal analgesia is a key component of these protocols, including regional analgesia techniques such as thoracic epidural analgesia (TEA), transversus abdominis plane (TAP), rectus sheath blocks or continuous wound infiltration (CWI)/catheters, and spinal anesthesia. We compare and contrast regional anesthesia approaches in different institutional colorectal surgery ERAS protocols...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28742427/a-comparison-of-multimodal-analgesic-approaches-in-institutional-enhanced-recovery-after-surgery-protocols-for-colorectal-surgery-pharmacological-agents
#19
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Enhanced Recovery After Surgery (ERAS(®)) protocols are the cornerstone of improved recovery after colorectal surgery. Their implementation leads to reduced morbidity and shorter hospital stays while attenuating the surgical stress response. Multimodal analgesia is an important part of ERAS protocols. We compared and contrasted protocols from 15 institutions to test our hypothesis that there is a fundamental consensus among them. MATERIALS AND METHODS: ERAS protocols for open and laparoscopic colorectal surgery were compared from 15 different healthcare facilities...
September 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28700983/intratumoral-coagulation-by-radiofrequency-ablation-facilitated-the-laparoscopic-resection-of-giant-hepatic-hemangioma-a-surgical-technique-report-of-two-cases
#20
Shaohong Wang, Jun Gao, Mengmeng Yang, Shan Ke, Xuemei Ding, Jian Kong, Li Xu, Wenbing Sun
BACKGROUND: Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5...
July 5, 2017: Oncotarget
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