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ERAS

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54 papers 500 to 1000 followers Enhanced recovery after surgery
By Christian Zalai Colorectal surgeon based in Montreal
https://www.readbyqxmd.com/read/29101566/impact-of-minimally-invasive-surgery-on-short-term-outcomes-after-rectal-resection-for-neoplasm-within-the-setting-of-an-enhanced-recovery-program
#1
Allison N Martin, Puja Shah Berry, Charles M Friel, Traci L Hedrick
BACKGROUND: Minimally invasive surgery (MIS) for rectal cancer has increased in recent years. Enhanced recovery (ER) protocols are associated with improved outcomes, such as decreased length of stay (LOS). We examined the impact of MIS and ER protocols on outcomes after rectal resection for neoplasm. METHODS: A retrospective analysis was performed for patients undergoing elective open (OS) or MIS rectal resection for neoplasm from 2010 to 2015 at a single institution...
November 3, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28940567/perioperative-fluid-and-hemodynamic-management-within-an-enhanced-recovery-pathway
#2
REVIEW
Michael W Manning, William Jonathan Dunkman, Timothy E Miller
Goal-directed fluid therapy (GDFT) seeks to improve outcomes through individualized optimization of oxygen delivery using IV fluid and vasoactive infusions. Trials of GDFT show clinical benefits over traditional liberal fluid administration, but fail to demonstrate benefits when compared to a restrictive strategy within an optimized enhanced recovery protocol. The ideal monitors, hemodynamic goals, and fluid administration strategy are not well established but may be less important than rational application of thoughtful fluid management strategies...
October 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28916971/emergency-room-visits-and-readmissions-following-implementation-of-an-enhanced-recovery-after-surgery-ieras-program
#3
Trevor Wood, Mary-Anne Aarts, Allan Okrainec, Emily Pearsall, J Charles Victor, Marg McKenzie, Ori Rotstein, Robin S McLeod
BACKGROUND: Enhanced Recovery After Surgery (ERAS) guidelines have been widely promoted and supported largely due to several studies showing decreased post-operative complications and length of stay. The objective of this study was to review the emergency room (ER) visits and readmission rates and reasons for both in patients who were part of the Implementation of an Enhanced Recovery After Surgery (iERAS) program for colorectal surgery. METHODS: All patients having elective colorectal surgery at 15 academic hospitals were enrolled in the iERAS program...
September 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28386715/radiologically-determined-sarcopenia-predicts-morbidity-and-mortality-following-abdominal-surgery-a-systematic-review-and-meta-analysis
#4
REVIEW
Keaton Jones, Alex Gordon-Weeks, Claire Coleman, Michael Silva
BACKGROUND: Individualised risk prediction is crucial if targeted pre-operative risk reduction strategies are to be deployed effectively. Radiologically determined sarcopenia has been shown to predict outcomes across a range of intra-abdominal pathologies. Access to pre-operative cross-sectional imaging has resulted in a number of studies investigating the predictive value of radiologically assessed sarcopenia over recent years. This systematic review and meta-analysis aimed to determine whether radiologically determined sarcopenia predicts post-operative morbidity and mortality following abdominal surgery...
September 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27997472/ensuring-early-mobilization-within-an-enhanced-recovery-program-for-colorectal-surgery-a-randomized-controlled-trial
#5
RANDOMIZED CONTROLLED TRIAL
Julio Flavio Fiore, Tanya Castelino, Nicolò Pecorelli, Petru Niculiseanu, Saba Balvardi, Olivia Hershorn, Sender Liberman, Patrick Charlebois, Barry Stein, Franco Carli, Nancy E 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...
August 2017: Annals of Surgery
https://www.readbyqxmd.com/read/27762436/network-meta-analysis-of-protocol-driven-care-and-laparoscopic-surgery-for-colorectal-cancer
#6
REVIEW
A C Currie, G Malietzis, J T Jenkins, T Yamada, H Ashrafian, T Athanasiou, K Okabayashi, R H Kennedy
BACKGROUND: Laparoscopic approaches and standardized recovery protocols have reduced morbidity following colorectal cancer surgery. As the optimal regimen remains inconclusive, a network meta-analysis was undertaken of treatments for the development of postoperative complications and mortality. METHODS: MEDLINE, Embase, trial registries and related reviews were searched for randomized trials comparing laparoscopic and open surgery within protocol-driven or conventional perioperative care for colorectal cancer resection, with complications as a defined endpoint...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27530446/morphine-promotes-colonization-of-anastomotic-tissues-with-collagenase-producing-enterococcus-faecalis-and-causes-leak
#7
Baddr A Shakhsheer, Luke A Versten, James N Luo, Jennifer R Defazio, Robin Klabbers, Scott Christley, Alexander Zaborin, Kristina L Guyton, Monika Krezalek, Daniel P Smith, Nadim J Ajami, Joseph F Petrosino, Irma D Fleming, Natalia Belogortseva, Olga Zaborina, John C Alverdy
BACKGROUND: Despite ever more powerful antibiotics, newer surgical techniques, and enhanced recovery programs, anastomotic leaks remain a clear and present danger to patients. Previous work from our laboratory suggests that anastomotic leakage may be caused by Enterococcus faecalis strains that express a high collagenase phenotype (i.e., collagenolytic). Yet the mechanisms by which the practice of surgery shifts or selects for collagenolytic phenotypes to colonize anastomotic tissues remain unknown...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/25894417/starting-a-surgical-home
#8
Michael J Englesbe, Alisha D Lussiez, Jeffrey F Friedman, June A Sullivan, Stewart C Wang
No abstract text is available yet for this article.
December 2015: Annals of Surgery
https://www.readbyqxmd.com/read/25892597/even-modest-hypoalbuminemia-affects-outcomes-of-colorectal-surgery-patients
#9
Zhobin Moghadamyeghaneh, Grace Hwang, Mark H Hanna, Michael J Phelan, Joseph C Carmichael, Steven D Mills, Alessio Pigazzi, Matthew O Dolich, Michael J Stamos
BACKGROUND: A small decrease in the serum albumin from the normal level is a common condition in preoperative laboratory tests of colorectal surgery patients; however, there is limited data examining these patients. We sought to identify outcomes of such patients. METHODS: The National Surgical Quality Improvement Program database was used to evaluate all patients who had modest levels of hypoalbuminemia (3 ≤ serum albumin < 3.5 g/dL) before colorectal resection from 2005 to 2012...
August 2015: American Journal of Surgery
https://www.readbyqxmd.com/read/25671587/the-impact-of-enhanced-recovery-protocol-compliance-on-elective-colorectal-cancer-resection-results-from-an-international-registry
#10
MULTICENTER STUDY
(no author information available yet)
BACKGROUND: The ERAS (enhanced recovery after surgery) care has been shown in randomized clinical trials to improve outcome after colorectal surgery compared to traditional care. The impact of different levels of compliance and specific elements, particularly out with a trial setting, is poorly understood. OBJECTIVE: This study evaluated the individual impact of specific patient factors and perioperative enhanced recovery protocol compliance on postoperative outcome after elective primary colorectal cancer resection...
June 2015: Annals of Surgery
https://www.readbyqxmd.com/read/25384994/use-of-a-pathway-quality-improvement-care-bundle-to-reduce-mortality-after-emergency-laparotomy
#11
MULTICENTER STUDY
S Huddart, C J Peden, M Swart, B McCormick, M Dickinson, M A Mohammed, N Quiney
BACKGROUND: Emergency laparotomies in the U.K., U.S.A. and Denmark are known to have a high risk of death, with accompanying evidence of suboptimal care. The emergency laparotomy pathway quality improvement care (ELPQuiC) bundle is an evidence-based care bundle for patients undergoing emergency laparotomy, consisting of: initial assessment with early warning scores, early antibiotics, interval between decision and operation less than 6 h, goal-directed fluid therapy and postoperative intensive care...
January 2015: British Journal of Surgery
https://www.readbyqxmd.com/read/24856316/short-stay-surgery-what-really-happens-after-discharge
#12
Tung T Tran, Pepa Kaneva, Nancy E Mayo, Gerald M Fried, Liane S Feldman
BACKGROUND: Although duration of hospital stay commonly is used as a surrogate outcome for surgical recovery, it is not applicable in the setting of short-stay surgery (<24 hours). The objective of our study was to describe the trajectory of recovery after short-stay abdominal surgery by using measures of physical activity and health-related quality of life (HRQL) and identify predictors of prolonged, postdischarge recovery. METHODS: Patients undergoing short-stay abdominal surgery were evaluated preoperatively and at 3 weeks and 2 months postoperatively...
July 2014: Surgery
https://www.readbyqxmd.com/read/24819094/improving-conventional-recovery-with-enhanced-recovery-in-minimally-invasive-surgery-for-rectal-cancer
#13
Wael Khreiss, Marianne Huebner, Robert R Cima, Eric R Dozois, Heidi K Chua, John H Pemberton, William S Harmsen, David W Larson
BACKGROUND: Enhanced recovery pathways have been shown to decrease the length of hospital stay in patients undergoing colorectal surgery. Few reports have studied patients undergoing minimally invasive surgery for rectal cancer. OBJECTIVE: Our aim was to review our experience in minimally invasive rectal cancer surgery. We report short-term outcomes and evaluate the potential advantages of the enhanced recovery protocol compared with our less intensive conventional pathway...
May 2014: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/22177541/a-pragmatic-multi-centre-randomised-controlled-trial-of-fluid-loading-in-high-risk-surgical-patients-undergoing-major-elective-surgery-the-foccus-study
#14
RANDOMIZED CONTROLLED TRIAL
Brian H Cuthbertson, Marion K Campbell, Stephen A Stott, Andrew Elders, Rodolfo Hernández, Dwayne Boyers, John Norrie, John Kinsella, Julie Brittenden, Jonathan Cook, Daniela Rae, Seonaidh C Cotton, David Alcorn, Jennifer Addison, Adrian Grant
INTRODUCTION: Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. METHODS: This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery...
2011: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/17513630/the-role-of-the-anesthesiologist-in-fast-track-surgery-from-multimodal-analgesia-to-perioperative-medical-care
#15
REVIEW
Paul F White, Henrik Kehlet, Joseph M Neal, Thomas Schricker, Daniel B Carr, Franco Carli
BACKGROUND: Improving perioperative efficiency and throughput has become increasingly important in the modern practice of anesthesiology. Fast-track surgery represents a multidisciplinary approach to improving perioperative efficiency by facilitating recovery after both minor (i.e., outpatient) and major (inpatient) surgery procedures. In this article we focus on the expanding role of the anesthesiologist in fast-track surgery. METHODS: A multidisciplinary group of clinical investigators met at McGill University in the Fall of 2005 to discuss current anesthetic and surgical practices directed at improving the postoperative recovery process...
June 2007: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/21597360/laparoscopy-in-combination-with-fast-track-multimodal-management-is-the-best-perioperative-strategy-in-patients-undergoing-colonic-surgery-a-randomized-clinical-trial-lafa-study
#16
RANDOMIZED CONTROLLED TRIAL
Malaika S Vlug, Jan Wind, Markus W Hollmann, Dirk T Ubbink, Huib A Cense, Alexander F Engel, Michael F Gerhards, Bart A van Wagensveld, Edwin S van der Zaag, Anna A W van Geloven, Mirjam A G Sprangers, Miguel A Cuesta, Willem A Bemelman
OBJECTIVE: To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. SUMMARY BACKGROUND DATA: Important developments in elective colorectal surgery are the introduction of laparoscopy and implementation of FT care, both focusing on faster recovery. METHODS: In a 9-center trial, patients eligible for segmental colectomy were randomized to laparoscopic or open colectomy, and to FT or standard care, resulting in 4 treatment groups...
December 2011: Annals of Surgery
https://www.readbyqxmd.com/read/23470575/sham-feeding-with-chewing-gum-after-elective-colorectal-resectional-surgery-a-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Patrick Lim, Owen James Morris, Gregory Nolan, Sarah Moore, Brian Draganic, Stephen Ridley Smith
OBJECTIVE: To determine whether sham feeding with chewing gum improved gastrointestinal recovery after colorectal resection surgery, in the presence of routine postoperative feeding. BACKGROUND: Sham feeding with chewing gum has been shown to accelerate the return of gut function after colorectal surgery. This study sought to determine whether sham feeding with gum, after colorectal resection, accelerates return of gastrointestinal function in patients on a rapid feeding enhanced recovery program...
June 2013: Annals of Surgery
https://www.readbyqxmd.com/read/21037443/rectal-cancer-surgery-with-or-without-bowel-preparation-the-french-greccar-iii-multicenter-single-blinded-randomized-trial
#18
RANDOMIZED CONTROLLED TRIAL
Frederic Bretagnol, Yves Panis, Eric Rullier, Philippe Rouanet, Stephane Berdah, Bertrand Dousset, Guillaume Portier, Stephane Benoist, Jacques Chipponi, Eric Vicaut
OBJECTIVE: To assess with a single-blinded, multicenter, randomized trial, the postoperative results in patients undergoing sphincter-saving rectal resection for cancer without preoperative mechanical bowel preparation (MBP). BACKGROUND: The collective evidence from literature strongly suggests that MBP, before elective colonic surgery, is of no benefit in terms of postoperative morbidity. Very few data and no randomized study are available for rectal surgery and preliminary results conclude toward the safety of rectal resection without MBP...
November 2010: Annals of Surgery
https://www.readbyqxmd.com/read/24627256/early-oral-feeding-vs-traditional-feeding-in-patients-undergoing-elective-open-bowel-surgery-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
M Pragatheeswarane, R Muthukumarassamy, D Kadambari, Vikram Kate
OBJECTIVE: This prospective randomized controlled trial was conducted to compare the safety, tolerability and outcome of early oral feeding vs. traditional feeding in patients undergoing elective open bowel surgery. METHODS: A total of 120 consecutive patients who underwent elective open bowel surgeries were randomized into either early feeding (n = 60) or traditional feeding group (n = 60). Patients in the early feeding group were started on oral fluids on post-operative day 1, while those in the traditional feeding group were started orals after the resolution of ileus...
May 2014: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/24096762/impact-of-epidural-analgesia-on-mortality-and-morbidity-after-surgery-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
REVIEW
Daniel M Pöpping, Nadia Elia, Hugo K Van Aken, Emmanuel Marret, Stephan A Schug, Peter Kranke, Manuel Wenk, Martin R Tramèr
OBJECTIVE: To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia. BACKGROUND: It remains controversial whether adding epidural analgesia to general anesthesia decreases postoperative morbidity and mortality. METHODS: We searched CENTRAL, EMBASE, PubMed, CINAHL, and BIOSIS till July 2012. We included randomized controlled trials comparing epidural analgesia (with local anesthetics, lasting for ≥ 24 hours postoperatively) with systemic analgesia in adults having surgery under general anesthesia, and reporting on mortality or any morbidity endpoint...
June 2014: Annals of Surgery
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