Activity Restriction Recommendations and Outcomes After Reconstructive Pelvic Surgery

Mueller, Margaret; Lewicky-Gaupp, Christina; Collins, Sarah A.; Abernethy, Melinda G.; Alverdy, Alex; Kenton, Kimberly

doi:10.1097/aog.0000000000001924

Cited by 33 publications

(24 citation statements)

References 13 publications

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“…A 6-week minimum period of pelvic rest is recommended on the basis of expert opinion from the task force. Interestingly, accumulating data suggest that the provision of liberal postoperative-activity recommendations may result in improved pelvic floor outcomes among women who underwent MIGS [9]. Discharge planning should begin preoperatively by counseling patients and their caregivers about criteria as opposed to time-based readiness for discharge.…”

Section: Preoperative Education and Counselingmentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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This is the first Enhanced Recovery After Surgery (ERAS) guideline dedicated to standardizing and optimizing perioperative care for women undergoing minimally invasive gynecologic surgery. The guideline was rigorously formulated by an American Association of Gynecologic Laparoscopists Task Force of US and Canadian gynecologic surgeons with special interest and experience in adapting ERAS practices for patients requiring minimally invasive gynecologic surgery. It builds on the 2016 ERAS Society recommendations for perioperative care in gynecologic/oncologic surgery by serving as a more comprehensive reference for minimally invasive endoscopic and vaginal surgery for both benign and malignant gynecologic conditions. For example, the section on preoperative optimization provides more specific recommendations derived from the ambulatory surgery and anesthesia literature for the management of anemia, hyperglycemia, and obstructive sleep apnea. Recommendations pertaining to multimodal analgesia account for the recent Food and Drug Administration warnings about respiratory depression from gabapentinoids. The guideline focuses on workflows important to high-value care in minimally invasive surgery, such as same-day discharge, and tackles controversial issues in minimally invasive surgery, such as thromboprophylaxis. In these ways, the guideline supports the American Association of Gynecologic Laparoscopists and our collective mission to elevate the quality and safety of healthcare for women through excellence in clinical practice.

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Section: Preoperative Education and Counselingmentioning

confidence: 99%

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Stone¹,

Carey

Fader³

et al. 2021

Journal of Minimally Invasive Gynecology

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show abstract

“…A deambulação precoce e o retorno às atividades físicas normais da pré-gravidez, assim que clinicamente seguros, podem reduzir as comorbidades associadas ao estilo de vida sedentário pós-cirúrgico. [108][109][110] As atividades físicas deverão ser retomadas em concordância com o obstetra. Na presença de doenças e ou complicações cardiovasculares, a avaliação conjunta do cardiologista tornase importante.…”

Section: Particularidades No Pós-parto Da Paciente Com Cardiopatiaunclassified

Posicionamento sobre Exercícios Físicos na Gestação e no Pós-Parto – 2021

Campos¹,

Buglia²,

Colombo³

et al. 2021

Arquivos Brasileiros De Cardiologia

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“…The restricted group was instructed to wait 12 weeks after surgery. Women who liberally resumed activities also reported fewer prolapse and urinary symptoms at 3 months 40 …”

Section: Resultsmentioning

confidence: 94%

“…Women who liberally resumed activities also reported fewer prolapse and urinary symptoms at 3 months. 40…”

Section: Early Mobilizationmentioning

confidence: 99%

A systematic review of best practices for the perioperative management of abdominal sacrocolpopexy

Nemirovsky

Herbert

Gorman

et al. 2020

Neurourology and Urodynamics

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Purpose Enhanced recovery after surgery (ERAS) pathways have been shown to reduce surgical morbidity and length of stay across various procedures. Our objective was to systematically evaluate the literature for best practices of ERAS elements in abdominal sacrocolpopexy (ASC), to determine if there is sufficient evidence to create best practice guidelines for this procedure. Materials and Methods Following the preferred reporting items for systematic review and meta‐analysis (PRISMA) statement, we performed a review using Pubmed, Embase, and Cochrane Library. Eligible articles contained ERAS components and postoperative outcomes of ASC published in English since 1997. Thirty‐five full‐text articles were selected for final qualitative analysis. Results Poor functional status before ASC was associated with a longer length of hospital stay. Laparoscopic ASC was associated with a shorter postoperative hospital stay, with no difference between laparoscopic and robotic approaches. Epidural analgesia in addition to spinal anesthesia lowered levels of pain throughout the postoperative stay in laparoscopic ASC. A multimodal bowel regimen shortened time to first bowel movement compared to a single agent regimen. Removing a Foley catheter may lead to sooner first spontaneous void but may result in higher rates of urinary retention and urinary tract infection. Studies investigating preoperative bowel preparation, preanesthesia medication, and multidose antimicrobial prophylaxis did not show significant benefit. Conclusions Best practices for ASC can be developed based on current findings from the literature and extrapolation of evidence from other surgeries where ASC‐specific elements are missing, with the ability to modify the pathways as new data become available.

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Activity Restriction Recommendations and Outcomes After Reconstructive Pelvic Surgery

Abstract: ClinicalTrials.gov, www.clinicaltrials.gov, NCT02138487.

Cited by 33 publications

References 13 publications

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Enhanced Recovery and Surgical Optimization Protocol for Minimally Invasive Gynecologic Surgery: An AAGL White Paper

Posicionamento sobre Exercícios Físicos na Gestação e no Pós-Parto – 2021

A systematic review of best practices for the perioperative management of abdominal sacrocolpopexy

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