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Enhanced recovery laparoscopic surgery

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https://www.readbyqxmd.com/read/29679338/c-reactive-protein-on-postoperative-day-1-a-predictor-of-early-intra-abdominal-infections-after-bariatric-surgery
#1
Dino Kröll, Dominik Nakhostin, Guido Stirnimann, Suna Erdem, Tobias Haltmeier, Philipp Christoph Nett, Yves Michael Borbély
BACKGROUND: Early intra-abdominal infections (IAI) compromise short-term outcomes in bariatric surgery. The timely detection of IAI is challenging but essential to prevent major sequelae of such complications. C-reactive protein (CRP) is a reliable marker for detecting IAI after colorectal surgery. In bariatric surgery, data on CRP as a marker for IAI are limited, particularly for postoperative day one (POD1). OBJECTIVE: The objective of this study was to assess CRP on POD1 as a predictor for early IAI (within 7 days following surgery) in patients after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB)...
April 21, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29679245/a-systematic-review-of-minimally-invasive-surgery-for-retrorectal-tumors
#2
REVIEW
T G Mullaney, A L Lightner, M Johnston, S R Kelley, D W Larson, E J Dozois
Retrorectal tumors are rare tumors that require resection for symptoms, malignancy and potential malignant transformation. Traditional approaches have included laparotomy, perineal excision or a combination. Multiple minimally invasive techniques are available which have the potential to minimize morbidity and enhance recovery. We performed a systematic review of the literature to determine the feasibility and surgical outcomes of retrorectal tumors approached using minimally invasive surgical techniques. Publications in which adult patients (≥ 18 years) had a minimally invasive approach (laparoscopic or robotic) for resection of a primary retrorectal tumor were included...
April 20, 2018: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29666000/how-does-the-application-of-surgical-components-in-enhanced-recovery-programs-for-colorectal-surgery-change-over-time
#3
Julie Veziant, Daniel Leonard, Bruno Pereira, Karem Slim
BACKGROUND: Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation. METHOD: Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage...
April 14, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29664800/randomized-controlled-trial-of-extended-perioperative-counseling-in-enhanced-recovery-after-colorectal-surgery
#4
Håvard Mjørud Forsmo, Christian Erichsen, Anne Rasdal, Jon Meyer Tvinnereim, Hartwig Körner, Frank Pfeffer
BACKGROUND: Enhanced recovery after surgery programs reduce the length of hospital stay in patients who undergo elective colorectal resection, but the reasons for this reduction are not well understood. OBJECTIVE: The aim of this randomized controlled trial was to assess the impact of extended perioperative counseling in treatment groups that were otherwise the same with respect to enhanced recovery after surgery criteria. DESIGN: Patients eligible for open or laparoscopic colorectal resection were randomly assigned to extended counseling (repeated information and guidance by a dedicated nurse) or standard counseling...
April 16, 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29659470/meta-analysis-of-perioperative-outcomes-of-acute-laparoscopic-vs-open-repair-of-perforated-gastroduodenal-ulcers
#5
Roberto Cirocchi, Kjetil Soreide, Salomone Di Saverio, Elena Rossi, Alberto Arezzo, Mauro Zago, Iosief Abraha, Nereo Vettoretto, Massimo Chiarugi
BACKGROUND: Surgery is the treatment of choice for perforated peptic ulcer disease (PUD). The aim of the present review is to compare the perioperative outcomes of acute laparoscopic versus open repair for PUD. METHODS: A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS and Web of Science RESULTS: The search included eight RCTs: 615 patients comparing laparoscopic (307 patients) versus open peptic perforated ulcer repair (308 patients)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29658665/-application-of-enhanced-recovery-program-in-laparoscopic-distal-pancreatectomy
#6
Yuan Ding, Zhongquan Sun, Wenyan Zhang, Xiangying Zhang, Yuancong Jiang, Sheng Yan, Weilin Wang
<b>Objective:</b> To evaluate the feasibility and safety of applying enhanced recovery after surgery (ERAS) protocol in patients undergoing laparoscopic distal pancreatectomy. <b>Methods:</b> Data of 36 patients undergoing laparoscopic distal pancreatectomy from May 2016 to May 2017 in the First Affiliated Hospital, Zhejiang University School of Medicine were reviewed. The patients were divided into ERAS group (<i>n</i>=12) and control group (<i>n</i>=24). The patients in ERAS group received a series of enhanced recovery procedures, including multimodal analgesia, early off-bed activity and early oral food-taking, etc...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/29649033/predictors-of-admission-after-the-implementation-of-an-enhanced-recovery-after-surgery-pathway-for-minimally-invasive-gynecologic-surgery
#7
Dayley S Keil, Lauren D Schiff, Erin T Carey, Janelle K Moulder, Amy M Goetzinger, Seema M Patidar, Lyla M Hance, Lavinia M Kolarczyk, Robert S Isaak, Paula D Strassle, Jay W Schoenherr
BACKGROUND: Enhanced recovery after surgery (ERAS) pathways in gynecologic surgery have been shown to decrease length of stay with no impact on readmission, but no study has assessed predictors of admission in this population. The purpose of this study was to identify predictors of admission after laparoscopic hysterectomy (LH) and robotic-assisted hysterectomy (RAH) performed under an ERAS pathway. METHODS: This is a prospective observational study of women undergoing LH/RAH for benign indications within an ERAS pathway...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29609882/-enhanced-recovery-after-surgery-protocol-versus-conventional-perioperative-care-in-colorectal-surgery-a-single-center-cohort-study
#8
Javier Ripollés-Melchor, María Luisa de Fuenmayor Varela, Susana Criado Camargo, Pablo Jerez Fernández, Álvaro Contreras Del Barrio, Eugenio Martínez-Hurtado, Rubén Casans-Francés, Alfredo Abad-Gurumeta, José Manuel Ramírez-Rodríguez, José María Calvo-Vecino
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols consist of a set of perioperative measures aimed at improving patient recovery and decreasing length of stay and postoperative complications. We assess the implementation and outcomes of an ERAS program for colorectal surgery. METHODS: Single center observational study. Data were collected from consecutive patients undergoing open or laparoscopic colorectal surgery during 2 time periods, 3 years before (Pre-ERAS) and 2 years after (Post-ERAS) the implementation of an ERAS protocol...
March 30, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29592983/rare-cause-of-fever-of-unknown-origin-gastrointestinal-stromal-tumour
#9
Manjunath Havalappa Dodamani, Rajiv Ranjan Kumar, Mayur Parkhi, Rajendar Basher
A 44-year-old man presented with fever (low to high grade) for 2-month duration despite treatment with oral antibiotics and antipyretics. Further, enquiry did not yield any potentially explanatory clues to a diagnosis. Physical examination revealed only left axillary lymphadenopathy, but was otherwise unremarkable. A number of diagnosis included tuberculosis, malignancy, lymphoma, connective disease disorder and infective endocarditis. Further evaluation revealed severe anaemia due to iron deficiency which was supported with blood transfusion and oral iron supplementation...
March 28, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29577221/-application-of-robotic-and-laparoscopic-radical-total-gastrectomy-to-gastric-cancer-patients-with-body-mass-index-%C3%A2-24-kg-m-2
#10
Ting Cong, Guoxiao Liu, Kecheng Zhang, Yunhe Gao, Jianxin Cui, Xin Lan, Da Teng, Xiulin Huo, Bo Wei
OBJECTIVE: To compare the short-term outcomes between robotic and laparoscopic radical total gastrectomy in gastric cancer patients with BMI index ≥24 kg/m2 . METHOD: Clinical data of 93 gastric cancer patients who underwent robotic and laparoscopic radical total gastrectomy at PLA General Hospital from April 2016 to April 2017 were retrospectively analyzed. The retrospective cohort study was adopted. INCLUSION CRITERIA: preoperatively definite diagnosis of primary gastric cancer by endoscopy and biopsy; preoperative BMI ≥24 kg/m2 ; no previous abdominal surgery; no previous chemotherapy and radiotherapy; no distant metastasis or invasion into adjacent organs before operation or during operation; receiving radical gastrectomy; Roux-en-Y reconstruction of digestive tract in open procedure...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29567060/laparoscopic-sleeve-gastrectomy-as-a-viable-option-for-an-ambulatory-surgical-procedure-our-52-month-experience
#11
Sepehr Lalezari, Matthew C Musielak, Lisa A Broun, Trace W Curry
BACKGROUND: We present our experience with same-day discharge (without an overnight stay) after laparoscopic sleeve gastrectomy (SG) in 821 consecutive patients from 2011 to 2015. This is the largest series published to date of patients undergoing ambulatory surgery for such a procedure. OBJECTIVES: To review our outcomes from ambulatory SG over 52 months to determine if SG can be safely performed in the ambulatory setting. SETTING: Ambulatory surgery center...
February 17, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29555468/an-enhanced-recovery-program-for-bariatric-surgical-patients-significantly-reduces-perioperative-opioid-consumption-and-postoperative-nausea
#12
Adam B King, Matthew D Spann, Patrick Jablonski, Jonathan P Wanderer, Warren S Sandberg, Matthew D McEvoy
BACKGROUND: Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients. OBJECTIVES: To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions...
February 13, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29553101/pain-perception-after-colorectal-surgery-a-propensity-score-matched-prospective-cohort-study
#13
Fabian Grass, Matthieu Cachemaille, David Martin, Nicolas Fournier, Dieter Hahnloser, Catherine Blanc, Nicolas Demartines, Martin Hübner
The purpose of this prospective cohort study was to compare multimodal pain management and pain perception after open vs. laparoscopic colorectal surgery within enhanced recovery care. Pain scores at rest and at mobilization were prospectively assessed in consecutive patients using Visual Analog Scales (VAS 0-10) and consumption of different analgesics was recorded daily until 96 hours postoperatively. Uni- and multivariate risk factors for pain peaks (≥ 4/10) were identified by logistic regression and compared between two propensity score matched groups (open vs...
2018: Bioscience Trends
https://www.readbyqxmd.com/read/29521264/application-of-eras-enhanced-recovery-after-surgery-and-laparoscopic-surgery-in-the-management-of-patients-with-bladder-cancer
#14
Rafael Uña Orejón, Estrella Mateo Torres, Iván Huercio Martínez, Cristina Jofré Escudero, Juan Gómez Rivas, Jesús Díez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVE: The enhanced recovery after surgery program (ERAS) has become the base of perioperative management in various surgical specialties. However, limited data are available for radical cystectomy. METHODS: We have analyzed 124 patients undergoing radical cystectomy. For retrospective analysis, the patients were divided into two groups:Group A (n=72) included patients whose surgery was performed before the introduction of the ERAS protocol; and Group B (n=52) included patients who were treated following the items included in the ERAS protocol...
March 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29520440/procalcitonin-and-c-reactive-protein-as-early-markers-of-anastomotic-leak-after-laparoscopic-colorectal-surgery-within-an-enhanced-recovery-after-surgery-eras-program
#15
José Luis Muñoz, María Oliva Alvarez, Vicent Cuquerella, Elena Miranda, Carlos Picó, Raquel Flores, Marta Resalt-Pereira, Pedro Moya, Ana Pérez, Antonio Arroyo
BACKGROUND: C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program...
March 8, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29496229/intravenous-lidocaine-infusion
#16
G Soto, M Naranjo González, F Calero
Systemic lidocaine used in continuous infusion during the peri-operative period has analgesic, anti-hyperalgesic, as well as anti-inflammatory properties. This makes it capable of reducing the use of opioids and inhalational anaesthetics, and the early return of bowel function, and patient hospital stay. The aim of this narrative review was to highlight the pharmacology and indications for clinical application, along with new and interesting research areas. The clinical applications of peri-operative lidocaine infusion have been reviewed in several recent systematic reviews and meta-analyses in patients undergoing open and laparoscopic abdominal procedures, ambulatory procedures, and other types of surgery...
February 26, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29470772/robotics-confers-an-advantage-in-right-hemicolectomy-with-intracorporeal-anastomosis-when-matched-against-conventional-laparoscopy
#17
James Chi-Yong Ngu, Yvonne Ying-Ru Ng
Comparisons between robotic and laparoscopic right hemicolectomy have been confounded by variations in operative technique. This study evaluates the two procedures after standardizing the intraoperative steps and perioperative management. Patients who underwent robotic right hemicolectomy with intracorporeal bowel anastomosis between July 2015 and June 2017 were matched with a laparoscopic group. Perioperative management was in accordance to an enhanced recovery protocol. Outcomes and histopathological data were compared...
February 22, 2018: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29451415/clinical-and-economic-impact-of-an-enhanced-recovery-pathway-for-open-and-laparoscopic-rectal-surgery
#18
Richard Garfinkle, Marylise Boutros, Gabriela Ghitulescu, Carol-Ann Vasilevsky, Patrick Charlebois, Sender Liberman, Barry Stein, Liane S Feldman, Lawrence Lee
BACKGROUND: The short-term benefits of laparoscopy for rectal surgery are equivocal. The objective of this study was to determine the clinical and economic impact of an enhanced recovery pathway (ERP) for laparoscopic and open rectal surgery. MATERIALS AND METHODS: All patients who underwent elective rectal resection with primary anastomosis between January 2009 and March 2012 at two tertiary-care, university-affiliated institutions were identified. Patients who met inclusion criteria were divided into four groups, according to surgical approach (laparoscopic [lap] or open) and perioperative management (ERP or conventional care [CC])...
February 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29398871/application-value-of-enhanced-recovery-after-surgery-for-total-laparoscopic-uncut-roux-en-y-gastrojejunostomy-after-distal-gastrectomy
#19
Yi-Feng Zang, Feng-Zhou Li, Zhi-Peng Ji, Yin-Lu Ding
AIM: To evaluate the safety and feasibility of enhanced recovery after surgery (ERAS) for total laparoscopic uncut Roux-en-Y gastrojejunostomy after distal gastrectomy. METHODS: The clinical data of 42 patients who were divided into an ERAS group (n = 20) and a control group (n = 22) were collected. The observed indicators included operation conditions, postoperative clinical indexes, and postoperative serum stress indexes. Measurement data following a normal distribution are presented as mean ± SD and were analyzed by t-test...
January 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29382673/effectiveness-of-an-internet-based-perioperative-care-programme-to-enhance-postoperative-recovery-in-gynaecological-patients-cluster-controlled-trial-with-randomised-stepped-wedge-implementation
#20
Esther V A Bouwsma, Judith A F Huirne, Peter M van de Ven, Antonie Vonk Noordegraaf, Frederieke G Schaafsma, Steven E Schraffordt Koops, Paul J M van Kesteren, Hans A M Brölmann, Johannes R Anema
OBJECTIVE: To evaluate the implementation and effectiveness of an internet-based perioperative care programme for patients following gynaecological surgery for benign disease. DESIGN: Stepped-wedge cluster randomised controlled trial. SETTING: Secondary care, nine hospitals in the Netherlands, 2011-2014. PARTICIPANTS: 433 employed women aged 18-65 years scheduled for hysterectomy and/or laparoscopic adnexal surgery. INTERVENTIONS: An internet-based care programme was sequentially rolled out using a multifaceted implementation strategy...
January 30, 2018: BMJ Open
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