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Enhanced recovery programme

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https://www.readbyqxmd.com/read/28647727/patients-as-partners-in-enhanced-recovery-after-surgery-a-qualitative-patient-led-study
#1
Chelsia Gillis, Marlyn Gill, Nancy Marlett, Gail MacKean, Kathy GermAnn, Loreen Gilmour, Gregg Nelson, Tracy Wasylak, Susan Nguyen, Edamil Araujo, Sandra Zelinsky, Leah Gramlich
OBJECTIVES: Explore the experience of patients undergoing colorectal surgery within an Enhanced Recovery After Surgery (ERAS) programme. Use these experiential data to inform the development of a framework to support ongoing, meaningful patient engagement in ERAS. DESIGN: Qualitative patient-led study using focus groups and narrative interviews. Data were analysed iteratively using a Participatory Grounded Theory approach. SETTING: Five tertiary care centres in Alberta, Canada, following the ERAS programme...
June 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28640971/enhanced-recovery-programme-following-laparoscopic-colorectal-resection-for-elderly-patients
#2
Wei Gen Zeng, Meng Jia Liu, Zhi Xiang Zhou, Zhen Jun Wang
BACKGROUND: The aim of this study was to investigate the feasibility and safety of an enhanced recovery programme (ERP) in patients aged ≥75 years who undergo laparoscopic surgery for colorectal cancer. METHODS: Patients were divided into two groups according to perioperative management: the ERP group (Group A, n = 94) and the conventional perioperative care group (Group B, n = 157). The postoperative outcomes were compared between two groups. RESULTS: There were no differences in terms of age, gender, American Society of Anesthesiologists score, operative time or blood loss between two groups...
June 22, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28634646/the-role-of-robotics-in-the-invasive-management-of-bladder-cancer
#3
REVIEW
Pramit Khetrapal, Wei Shen Tan, Benjamin Lamb, Melanie Tan, Hilary Baker, James Thompson, Ashwin Sridhar, John D Kelly, Tim Briggs
Robot-assisted radical cystectomy (RARC) has been adopted widely in many centres, owed largely to the success of robot-assisted laparoscopic prostatectomy (RALP). It aims to replicate the oncological outcomes of open radical cystectomy (ORC), while providing a shorter recovery period. Despite this, previous RCTs have failed to show a benefit for RARC over ORC. These trials have compared extracorporeal RARC (eRARC) with ORC, which requires a further incision to mobilise the bowel for urinary reconstruction with an open technique...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#4
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28605474/digital-innovations-and-emerging-technologies-for-enhanced-recovery-programmes
#5
F Michard, T J Gan, H Kehlet
Enhanced recovery programmes (ERPs) are increasingly used to improve post-surgical recovery. However, compliance to various components of ERPs-a key determinant of success-remains sub-optimal. Emerging technologies have the potential to help patients and caregivers to improve compliance with ERPs.Preoperative physical condition, a major determinant of postoperative outcome, could be optimized with the use of text messages (SMS) or digital applications (Apps) designed to facilitate smoking cessation, modify physical activity, and better manage hypertension and diabetes...
June 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28464491/impact-of-avoiding-post-operative-urinary-catheters-on-outcomes-following-colorectal-resection-in-an-eras-programme-no-iduc-and-eras-programmes
#6
Samuel T Roberts, Kiraati Patel, Stephen R Smith
BACKGROUND: The presence of an indwelling urinary catheter (IDUC) is routine following colorectal resections. In Enhanced Recovery After Surgery programmes, excessive intravenous fluids (IVFs) are avoided. This study sought to determine whether the routine absence of an IDUC following colorectal surgery improved post-operative outcomes and minimized fluid prescription. METHODS: A retrospective comparative cohort study was performed on patients undergoing colorectal resection at a tertiary referral teaching hospital, over a 7-year period...
May 2, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28446786/how-and-why-do-t-cells-and-their-derived-cytokines-affect-the-injured-and-healthy-brain
#7
REVIEW
Anthony J Filiano, Sachin P Gadani, Jonathan Kipnis
The evolution of adaptive immunity provides enhanced defence against specific pathogens, as well as homeostatic immune surveillance of all tissues. Despite being 'immune privileged', the CNS uses the assistance of the immune system in physiological and pathological states. In this Opinion article, we discuss the influence of adaptive immunity on recovery after CNS injury and on cognitive and social brain function. We further extend a hypothesis that the pro-social effects of interferon-regulated genes were initially exploited by pathogens to increase host-host transmission, and that these genes were later recycled by the host to form part of an immune defence programme...
June 2017: Nature Reviews. Neuroscience
https://www.readbyqxmd.com/read/28428892/a-comparison-of-earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-compared-to-standard-care-rehab-study-protocol-for-a-single-site-randomised-controlled-feasibility-trial
#8
Catherine Snelson, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, David Thickett, Emma Reeves, Aisling McLaughlin, Lauren Cooper, David McWilliams
BACKGROUND: Mortality from critical illness is improving, but survivors suffer from prolonged weakness and psychological and cognitive impairments. Maximising the recovery after critical illness has been highlighted as a research priority, especially in relation to an ageing population who present with higher rates of pre-morbid disability. Small studies have shown that starting rehabilitation early within the intensive care unit (ICU) improves short-term outcomes. Systematic reviews have highlighted the need for robust multicentre randomised controlled trials with longer term follow-up...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28418057/geometry-dependent-compressive-responses-in-nanoimprinted-submicron-structured-shape-memory-polyurethane
#9
Wei Li Lee, Hong Yee Low, Christine Ortiz
High resolution surface textures, when rationally designed, provide an attractive surface engineering approach to enhance surface functionalities. Designing smart surfaces by coupling surface texture with shape memory polymers has garnered attention in achieving tunable mechanical properties. We investigate the structure-mechanical property relationships for programmable, shape-memorizing submicron-scale pillar arrays subjected to flat-punch compression. The geometrically-dependent deformation of structured surfaces with two different aspect ratios (250 nm-pillars 1 : 1 and 550 nm-pillars 2...
May 14, 2017: Soft Matter
https://www.readbyqxmd.com/read/28394033/recovery-stress-patterns-and-low-back-pain-differences-in-pain-intensity-and-disability
#10
Jahan Heidari, Tobias Mierswa, Monika Hasenbring, Jens Kleinert, Claudia Levenig, Johanna Belz, Michael Kellmann
BACKGROUND: Recovery describes a restoring process influencing the health conditions of individuals but a potential link to low back pain (LBP) has not been scrutinized so far. Psychological strategies to deal with LBP have been considered within the biopsychosocial approach but substantial evidence regarding specific psychological underpinnings remains elusive. The current study aimed to compare individuals with different recovery-stress patterns (i.e. specific combinations of recovery/stress) regarding their pain and disability in the lower back...
April 10, 2017: Musculoskeletal Care
https://www.readbyqxmd.com/read/28362132/identifying-patients-eligible-for-a-short-hospital-stay-after-stoma-closure
#11
Charles Sabbagh, Cyril Cosse, Lionel Rebibo, Hanane Hariz, Abdennaceur Dhahri, Jean Marc Regimbeau
INTRODUCTION: The implementation of enhanced recovery programmes after elective colorectal surgery has dramatically reduced the length of stay. The objective of this study was to assess the selection of good candidates for short post-operative stay (GCSS) in the context of stoma closure. METHODS: Between January 2011 and December 2014, 222 patients were included in the present retrospective, single-center study. The primary endpoint was the proportion of GCSS. We also identified factors associated with GCSS status and built a predictive score...
March 31, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28343221/abandoning-prophylactic-abdominal-drainage-after-hepatic-surgery-10-years-of-no-drain-policy-in-an-enhanced-recovery-after-surgery-environment
#12
Edgar M Wong-Lun-Hing, Victor van Woerden, Toine M Lodewick, Marc H A Bemelmans, Steven W M Olde Damink, Cornelis H C Dejong, Ronald M van Dam
BACKGROUND: Routine prophylactic abdominal drainage after hepatic surgery is still being debated, as it may be unnecessary, possibly harmful, and uncomfortable for patients. This study evaluated the safety of a no-drain policy after liver resection within an Enhanced Recovery after Surgery (ERAS) programme. METHODS: All hepatectomies performed without prophylactic drainage during 2005-2014 were included. Primary end points were resection-surface-related (RSR) morbidity, defined as the presence of postoperative biloma, hemorrhage or abscess, and reinterventions...
March 25, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28302377/stair-negotiation-as-a-rehabilitation-intervention-for-enhancing-recovery-following-total-hip-and-knee-replacement-surgery
#13
REVIEW
James P Gavin, Tikki Immins, Thomas Wainwright
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) are common orthopaedic procedures. However, an optimal programme for post-operative rehabilitation has yet to be established. Stair negotiation is a challenging, habitual task, regularly used as a post-operative functional outcome measure; yet as a physical rehabilitation intervention it appears to be rarely used. AIM: The review purpose was to investigate the effectiveness of stair climbing as a rehabilitation intervention for THR and TKR patients...
May 2017: International Journal of Orthopaedic and Trauma Nursing
https://www.readbyqxmd.com/read/28272849/enhanced-recovery-after-surgery-eras-in-penetrating-abdominal-trauma-a-prospective-single-center-pilot-study
#14
M R Moydien, R Oodit, S Chowdhury, S Edu, A J Nicol, P H Navsaria
BACKGROUND: Enhanced recovery after surgery (ERAS) programmes employed in elective surgery have provided strong evidence for decreased lengths of hospital stay without increase in postoperative complications. The aim of this study was to explore the role and benefits of ERAS implemented in patients undergoing emergency laparotomy for penetrating abdominal trauma. METHOD: Institutional University of Cape Town Human Research Ethics Committee (UCT-HREC) approved study...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28265731/primary-surgery-for-malignant-large-bowel-obstruction-postoperative-nasogastric-tube-reinsertion-is-not-mandatory
#15
A Venara, J Barbieux, P A Colas, A Le Fouler, E Lermite, A Hamy
BACKGROUND: Malignant large bowel obstructions frequently require emergency surgery. Compliance with enhanced recovery after surgery programmes is significantly reduced due to non-removal of the nasogastric tube in the postoperative period. The first aim of the present study was to research factors associated with the failure of immediate nasogastric tube removal in patients who had undergone emergency surgery for malignant large bowel obstruction. The second aim was to assess the morbidity linked to nasogastric tube reinsertion...
July 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28228448/patient-experience-with-discharge-instructions-in-postdischarge-recovery-a-qualitative-study
#16
Molly J Horstman, Whitney L Mills, Levi I Herman, Cecilia Cai, George Shelton, Tareq Qdaisat, David H Berger, Aanand D Naik
OBJECTIVES: We examined the role of discharge instructions in postoperative recovery for patients undergoing colorectal surgery and report themes related to patient perceptions of discharge instructions and postdischarge experience. DESIGN: Semistructured interviews were conducted as part of a formative evaluation of a Project Re-Engineered Discharge intervention adapted for surgical patients. SETTING: Michael E. DeBakey VA Medical Center, a tertiary referral centre in Houston, Texas...
February 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28220543/the-beneficial-attributes-of-visual-art-making-in-cancer-care-an%C3%A2-integrative-review
#17
G Ennis, M Kirshbaum, N Waheed
We seek to understand what is known about the use of visual art-making for people who have a cancer diagnosis, and to explore how art-making may help address fatigue in the cancer care context. Art-making involves creating art or craft alone or in a group and does not require an art-therapist as the emphasis is on creativity rather than an overt therapeutic intention. An integrative review was undertaken of qualitative, quantitative and mixed-method studies on art-making for people who have cancer, at any stage of treatment or recovery...
February 21, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28214097/impact-of-an-enhanced-recovery-after-surgery-programme-in-radical-cystectomy-a-cohort-comparative-study
#18
R Casans-Francés, A T Roberto-Alcácer, A C García-Lecina, M L Ferrer-Ferrer, J Subirá-Ríos, J Guillén-Antón
OBJECTIVE: To evaluate the results of the implementation of an enhanced recovery program (ERAS) for open approach radical cystectomy compared to the historical cohort of the same hospital. MATERIAL AND METHODS: A retrospective analysis of 138 consecutive patients who underwent radical cystectomy with Bricker or Studer ileal derivation (97 historical vs. 41 ERAS). Overall complication rate, Clavien-Dindo stage>2 complications, mortality, hospital and critical care length of stay and readmission rates, as well as need for reoperation, nasogastric intubation, transfusion or parenteral nutrition were compared...
June 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28207724/psychosocial-enhancement-of-the-green-prescription-for-obesity-recovery-a-randomised-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Doug Sellman, Ria Schroder, Daryle Deering, Jane Elmslie, James Foulds, Chris Frampton
AIMS: Kia Ākina is a low-cost obesity recovery network providing ongoing addiction-orientated psychosocial support. This study explored the impact of Kia Ākina when added to the Green Prescription, a key government-funded health promotion programme in New Zealand. METHODS: A randomised controlled trial (ACTRN12613001160729) involving 108 participants recruited from primary care compared Green Prescription plus Kia Ākina (KA/GRx) with Green Prescription alone (GRx) over 12 months...
February 17, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28176194/enhanced-recovery-in-lower-limb-arthroplasty-in-the-irish-setting
#20
J G Galbraith, C Fenelon, J Gibbons, G A Kelly, D Bennett
BACKGROUND: In the current economic climate of staff shortages and bed closures, orthopaedic surgeons must look for system efficiencies. Enhanced Recovery Programmes (ERP) have the potential not only to reduce length of stay (LOS) and concurrent costs but also to improve patient outcomes. The aim of this paper is to evaluate the effect of ERP for primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) on length of stay (LOS) in the Irish Setting. METHODS: A single-surgeon retrospective case-control study was conducted comparing those who underwent primary lower limb arthroplasty before and after the introduction of an ERP...
February 7, 2017: Irish Journal of Medical Science
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