collection
https://read.qxmd.com/read/17513630/the-role-of-the-anesthesiologist-in-fast-track-surgery-from-multimodal-analgesia-to-perioperative-medical-care
#21
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://read.qxmd.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
#22
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://read.qxmd.com/read/23470575/sham-feeding-with-chewing-gum-after-elective-colorectal-resectional-surgery-a-randomized-clinical-trial
#23
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://read.qxmd.com/read/21037443/rectal-cancer-surgery-with-or-without-bowel-preparation-the-french-greccar-iii-multicenter-single-blinded-randomized-trial
#24
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://read.qxmd.com/read/24627256/early-oral-feeding-vs-traditional-feeding-in-patients-undergoing-elective-open-bowel-surgery-a-randomized-controlled-trial
#25
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
https://read.qxmd.com/read/24096762/impact-of-epidural-analgesia-on-mortality-and-morbidity-after-surgery-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#26
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
https://read.qxmd.com/read/24368573/enhanced-recovery-program-in-colorectal-surgery-a-meta-analysis-of-randomized-controlled-trials
#27
REVIEW
Massimiliano Greco, Giovanni Capretti, Luigi Beretta, Marco Gemma, Nicolò Pecorelli, Marco Braga
BACKGROUND: Meta-analyses in the literature show that enhanced recovery after surgery (ERAS) is associated with lower morbidity rate and shorter hospital stay after elective colorectal surgery. However, a recent Cochrane review did not indicate the ERAS pathway as being the new standard of care due to the limited number of published trials, together with their poor quality. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess the impact of the ERAS pathway on overall morbidity, single postoperative complications, length of hospital stay, and readmission rate following colorectal surgery...
June 2014: World Journal of Surgery
https://read.qxmd.com/read/23905554/the-impact-of-intravenous-fluid-administration-on-complication-rates-in-bowel-surgery-within-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#28
RANDOMIZED CONTROLLED TRIAL
J Zakhaleva, J Tam, P I Denoya, M Bishawi, R Bergamaschi
AIM: A randomized controlled trial was conducted to test the hypothesis that there is no difference in complications in patients receiving intravenous (iv) water and electrolyte, based on either stroke volume or clinical indicators at bowel surgery. METHOD: Eligible patients were randomized either to intra-operative iv administration of fluid boluses based on stroke volume measured by oesophageal Doppler (probe arm) or to iv fluid based on clinical indicators (no-probe arm)...
July 2013: Colorectal Disease
https://read.qxmd.com/read/22687136/early-prediction-of-adverse-events-in-enhanced-recovery-based-upon-the-host-systemic-inflammatory-response
#29
JOURNAL ARTICLE
J C Lane, S Wright, J Burch, R H Kennedy, J T Jenkins
AIM: Early identification of patients experiencing postoperative complications is imperative for successful management. C-reactive protein (CRP) is a nonspecific marker of inflammation used in many specialties to monitor patient condition. The role of CRP measurement early in the elective postoperative colorectal patient is unclear, particularly in the context of enhanced recovery (ERAS). METHODS: Five hundred and thirty-three consecutive patients who underwent elective colorectal surgery between October 2008 and October 2010 within an established ERAS programme were studied...
February 2013: Colorectal Disease
https://read.qxmd.com/read/24567343/eras-enhanced-recovery-after-surgery-moving-evidence-based-perioperative-care-to-practice
#30
REVIEW
Olle Ljungqvist
ERAS is the acronym for enhanced recovery after surgery, a term often used to describe perioperative care programs that have been shown to improve outcomes after major surgery. This article gives a brief history of the development from fast-track surgery to ERAS. Today, the full meaning of ERAS goes beyond just a protocol for perioperative care with the initiation of a novel multiprofessional, multidisciplinary medical society: the Enhanced Recovery After Surgery Society for Perioperative Care (www.erassociety...
July 2014: JPEN. Journal of Parenteral and Enteral Nutrition
https://read.qxmd.com/read/22146943/enhanced-recovery-program-following-colorectal-resection-in-the-elderly-patient
#31
COMPARATIVE STUDY
Nikhil Pawa, Paul L Cathcart, Tan H A Arulampalam, Matthew G Tutton, Roger W Motson
BACKGROUND: The enhanced recovery program (ERP) aims to reduce the metabolic response to surgery, hastening recovery and shortening hospital stay. Concerns exist regarding morbidity and hospital stay in elderly patients. The present study aimed to compare the outcomes and compliance of elderly patients managed by an ERP protocol with a younger group. METHODS: A review was performed of a prospective database of patients undergoing colorectal resection managed under the ERP protocol between 2005 and 2010...
February 2012: World Journal of Surgery
https://read.qxmd.com/read/23982426/enhanced-recovery-after-elective-colorectal-resection-outside-a-strict-fast-track-protocol-a-single-centre-experience
#32
JOURNAL ARTICLE
A C Agrafiotis, M Corbeau, A Buggenhout, G Katsanos, B Ickx, J Van de Stadt
INTRODUCTION: Optimising the management of hospitalised patients is a major concern. In colorectal surgery, the concept of enhanced recovery has been popularised by means of "fast-track" protocols, aiming at patient's discharge on the second postoperative day. Nevertheless, a strict fast-track protocol has several limitations. It is very demanding for the patient and therefore applicable only to a limited number of patients. AIM: In order to optimise, in every aspect, the postoperative recovery of each patient undergoing an elective colorectal resection inside our institution, we set up a "soft" enhanced recovery programme...
January 2014: International Journal of Colorectal Disease
https://read.qxmd.com/read/24668455/enhanced-recovery-pathway-for-urgent-colectomy
#33
COMPARATIVE STUDY
Didier Roulin, Catherine Blanc, Mirza Muradbegovic, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
BACKGROUND: Enhanced recovery protocols have been proven to decrease complications and hospital stay following elective colorectal surgery. However, these principles have not yet been reported for urgent surgery procedures. We aimed to assess our initial experience with urgent colectomies performed within an established enhanced recovery pathway. METHODS: In a prospective cohort study, all patients undergoing colonic resection between April 2012 and March 2013 were treated according to a standardized enhanced recovery protocol...
August 2014: World Journal of Surgery
https://read.qxmd.com/read/22710280/enhanced-recovery-pathways-as-a-way-to-reduce-surgical-morbidity
#34
REVIEW
Michael P W Grocott, Daniel S Martin, Michael G Mythen
PURPOSE OF REVIEW: The aim of this review is to summarize important publications in enhanced recovery during 2010-2011 and to highlight key themes. Specifically, we focus on updated systematic reviews of high-quality clinical trials of enhanced recovery in colorectal surgery, exemplar studies of enhanced recovery in other specialties, and exploration of which elements of the enhanced recovery package might be associated with improved patient outcome. RECENT FINDINGS: An expanding evidence base of clinical trials and implementation evaluations supports the effectiveness of enhanced recovery programmes in improving outcome following major elective surgery...
August 2012: Current Opinion in Critical Care
https://read.qxmd.com/read/23568250/systematic-review-and-meta-analysis-of-enhanced-recovery-after-pancreatic-surgery-with-particular-emphasis-on-pancreaticoduodenectomies
#35
REVIEW
M M E Coolsen, R M van Dam, A A van der Wilt, K Slim, K Lassen, C H C Dejong
BACKGROUND: In the past decade, Enhanced Recovery after Surgery (ERAS) protocols have been implemented in several fields of surgery. With these protocols, a faster recovery and shorter hospital stay can be accomplished without an increase in morbidity or mortality. The purpose of this study was to review systematically the evidence for implementation of an ERAS protocol in pancreatic resections, with particular emphasis on pancreaticoduodenectomies (PDs). METHODS: A systematic search was performed in Medline, Embase, Pubmed, CINAHL, and the Cochrane library for papers describing an ERAS program in adult patients undergoing elective pancreatic surgery published between January 1966 and December 2012...
August 2013: World Journal of Surgery
https://read.qxmd.com/read/23070220/the-use-of-enhanced-recovery-after-surgery-eras-principles-in-scottish-orthopaedic-units-an-implementation-and-follow-up-at-1-year-2010-2011-a-report-from-the-musculoskeletal-audit-scotland
#36
JOURNAL ARTICLE
Nicholas B Scott, David McDonald, Jane Campbell, Richard D Smith, A Kate Carey, Ian G Johnston, Kate R James, Steffen J Breusch
OBJECTIVE: To establish whether a nationally guided programme can lead to more widespread implementation of enhanced recovery after surgery (ERAS), a well-established optimised care pathway for lower limb arthroplasty. DESIGN: In 2010, National Services Scotland's Musculoskeletal Audit was asked to perform a 'snapshot' audit of the current peri-operative management of patients undergoing total hip and knee arthroplasty in all 22 Scottish orthopaedic units with an identical follow-up audit in 2011 after input and support from the national steering group...
January 2013: Archives of Orthopaedic and Trauma Surgery
https://read.qxmd.com/read/22102090/enhanced-recovery-after-surgery-eras-program-attenuates-stress-and-accelerates-recovery-in-patients-after-radical-resection-for-colorectal-cancer-a-prospective-randomized-controlled-trial
#37
RANDOMIZED CONTROLLED TRIAL
Li Ren, Dexiang Zhu, Ye Wei, Xiangou Pan, Li Liang, Jianmin Xu, Yunshi Zhong, Zhanggang Xue, Ling Jin, Shaokang Zhan, Weixin Niu, Xinyu Qin, Zhaohan Wu, Zhaoguang Wu
BACKGROUND: The aim of this trial was to compare the Enhanced Recovery After Surgery (ERAS) program with conventional perioperative management in patients who underwent radical resection for colorectal cancer. METHODS: A combination of evidence-based and consensus methodology was used to develop the ERAS protocol. Five hundred ninety-seven consecutive patients who underwent elective colorectal resection were randomized to either the ERAS (n = 299) or the control group (n = 298)...
February 2012: World Journal of Surgery
https://read.qxmd.com/read/21242424/adherence-to-the-enhanced-recovery-after-surgery-protocol-and-outcomes-after-colorectal-cancer-surgery
#38
COMPARATIVE STUDY
Ulf O Gustafsson, Jonatan Hausel, Anders Thorell, Olle Ljungqvist, Mattias Soop, Jonas Nygren
OBJECTIVES: To study the impact of different adherence levels to the enhanced recovery after surgery (ERAS) protocol and the effect of various ERAS elements on outcomes following major surgery. DESIGN: Single-center prospective cohort study before and after reinforcement of an ERAS protocol. Comparisons were made both between and across periods using multivariate logistic regression. All clinical data (114 variables) were prospectively recorded. SETTING: Ersta Hospital, Stockholm, Sweden...
May 2011: Archives of Surgery
https://read.qxmd.com/read/23352608/discharge-within-24-to-72-hours-of-colorectal-surgery-is-associated-with-low-readmission-rates-when-using-enhanced-recovery-pathways
#39
JOURNAL ARTICLE
Justin K Lawrence, Deborah S Keller, Hoda Samia, Bridget Ermlich, Karen M Brady, Tamar Nobel, Sharon L Stein, Conor P Delaney
BACKGROUND: Enhanced Recovery Pathways (ERPs) have demonstrated reduced hospital length of stay and improved outcomes after colorectal surgery. Concerns exist about increases in readmission rates. Laparoscopic colorectal surgery with an ERP can permit earlier discharge without compromising safety or increasing readmission rates. STUDY DESIGN: A review of a prospective database was performed for major elective colorectal procedures by a single surgeon. All patients followed a standardized ERP and discharge criteria...
March 2013: Journal of the American College of Surgeons
https://read.qxmd.com/read/23810575/outcomes-of-discharge-after-elective-laparoscopic-colorectal-surgery-with-transversus-abdominis-plane-blocks-and-enhanced-recovery-pathway
#40
JOURNAL ARTICLE
Joanne Favuzza, Conor P Delaney
BACKGROUND: Enhanced recovery pathways (ERP) have been well shown to permit early recovery and discharge. The addition of a transversus abdominis plane (TAP) block to a standard pathway may improve these outcomes. We evaluated the addition of a TAP block to an established ERP. STUDY DESIGN: One hundred consecutive patients underwent elective laparoscopic colectomy by a single surgeon. A laparoscopic-guided TAP block was administered at the end of the procedure. Patients followed an established ERP that included overnight intravenous patient-controlled analgesia pump, diet and oral analgesia on postoperative day 1, and standardized discharge criteria...
September 2013: Journal of the American College of Surgeons
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