Enhanced Recovery After Surgery: Exploring the Advances and Strategies

Jain, Shubhi N; Lamture, Yashwant; Krishna, Malay

doi:10.7759/cureus.47237

Cited by 5 publications

(1 citation statement)

References 58 publications

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“…The Enhanced Recovery After Surgery Program (ERAS) program, an evidence-based, multidisciplinary perioperative care pathway, is designed to achieve early recovery after surgery by maintaining preoperative organ functions and reducing post-operative reactions [6][7][8]. ERAS has also been shown to be associated with the improvement of postoperative outcomes, including reduced LOS and the rate of pulmonary and cardiac complications after thoracic surgery [9,10].…”

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confidence: 99%

Length of Postoperative Hospital Stay and Related Factors After Lobectomy for Lung Cancer: A Pre-enhanced Recovery After Surgery (ERAS) Single Center Assessment

Tat Bang,

Thanh Vy,

Tap

2024

Cureus

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Background: Lobectomy for lung cancer often presents a lot of potentially severe complications after surgery for patients. Enhanced Recovery After Surgery (ERAS) is a program to improve unexpected events. When implementing ERAS, there needs to be evidence of relevant factors that prolong hospital stays to encourage the participation of medical staff and leaders. This study is to determine the length of hospital stay (LOS) and its related factors after surgery in patients undergoing lobectomy for non-small cell lung cancer.Methods: A descriptive retrospective study was conducted on 99 patients undergoing lobectomy for nonsmall cell lung cancer at University Medical Center Ho Chi Minh City. Data were extracted from a computerized database of patients who were hospitalized for lobectomy in the treatment of non-small cell lung cancer from January 2018 to December 2021. The primary outcome was the postoperative LOS.Results: Median postoperative LOS was 5.2 days (interquartile range 4.8 to 6.8 days). The complication rate was 19.2%, of which Clavien-Dindo II accounted for the highest at 9.1%. The 30-day readmission rate was 13.1%. The median of LOS in the current cigarette smoker's group was 1.9 days higher than the nevercigarette smoker's group and 1.5 days higher than the former cigarette smokers (p<0.001). Tumor-nodesmetastasis (TNM) stage III showed the highest LOS compared to other stages (p=0.029). Open surgery and thoracoscopic conversion to open showed postoperative LOS about two days longer than thoracoscopic surgery (p<0.001). Performing muscle relaxation and early extubation, multimodal analgesia reduced postoperative LOS by 1.6 days (p<0.001), and preoperative physical therapy and early physical therapy at recovery reduced postoperative LOS by 1.3 days (p<0.001). There was a strong positive correlation between the duration of endotracheal retention, duration of thoracic drainage, amount of blood loss, and postoperative LOS (R>0.5, p<0.001). The duration of the Post-Anesthesia Care Unit and fasting time after surgery showed an average positive correlation with postoperative LOS (0.3

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Section: Introductionmentioning

confidence: 99%

Length of Postoperative Hospital Stay and Related Factors After Lobectomy for Lung Cancer: A Pre-enhanced Recovery After Surgery (ERAS) Single Center Assessment

Tat Bang,

Thanh Vy,

Tap

2024

Cureus

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ERAS and Gastrointestinal Site Infections: Insights from a Comprehensive Systematic Review and Meta-Analysis

Wu,

Ge,

Shi

2024

Surgical Infections

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Exploring the effects of post operative hyperoxic intermittent stimuli on reticulocyte levels in cancer patients: a randomized controlled study

Khalife,

Salvagno,

Sosnowski

et al. 2024

J Anesth Analg Crit Care

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Background Anemia is common among hospitalized critically ill and surgical oncological patients. The rising incidence of cancer and aggressive treatments has increased the demand for blood products, further strained by a dwindling donor pool. The normobaric oxygen paradox (NOP) has emerged as a potential avenue to increase EPO levels. While some studies support its efficacy, research remains limited in clinical settings. This study aims to assess the effectiveness of a NOP protocol in stimulating erythropoiesis, as measured by changes in reticulocyte counts, in cancer patients undergoing abdominal surgeries. Methods This is a post hoc analysis of a prospective, single-center, controlled, randomized study. A total of 49 patients undergoing abdominal surgery were analyzed at the Institut Jules Bordet. Adult patients admitted to the intensive care unit (ICU) for at least 24 h were enrolled, excluding those with severe renal insufficiency or who received transfusions during the study period. Participants were randomized into two groups: a normobaric oxygen paradox (OXY) group who received 60% oxygen for 2 h on days 1, 3, and 5 post-surgery and a control (CTR) group who received standard care. Data on baseline characteristics, surgical details, and laboratory parameters were collected. Statistical analysis included descriptive statistics, chi-square tests, t-tests, Mann–Whitney tests, and linear and logistic regression. Results The final analysis included 33 patients (median age 62 [IQR 58–66], 28 (84.8%) males, with no withdrawals or deaths during the study period. No significant differences were observed in baseline surgical characteristics or perioperative outcomes between the two groups. In the OXY group (n = 16), there was a significant rise (p = 0.0237) in the percentage of reticulocyte levels in comparison to the CTR group (n = 17), with median values of 36.1% (IQR 20.3–57.8) versus − 5.3% (IQR − 19.2–57.8), respectively. The increases in hemoglobin and hematocrit levels did not significantly differ between the groups when compared to their baselines’ values. Conclusions This study provides preliminary evidence supporting the potential of normobaric oxygen therapy in stimulating erythropoiesis in cancer patients undergoing abdominal surgeries. While the OXY group resulted in increased reticulocyte counts, further research with larger sample sizes and multi-center trials is warranted to confirm these findings. Trial registration The study was retrospectively registered under NCT number 06321874 on The 10th of April 2024.

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Enhanced Recovery After Surgery: Exploring the Advances and Strategies

Cited by 5 publications

References 58 publications

Length of Postoperative Hospital Stay and Related Factors After Lobectomy for Lung Cancer: A Pre-enhanced Recovery After Surgery (ERAS) Single Center Assessment

Length of Postoperative Hospital Stay and Related Factors After Lobectomy for Lung Cancer: A Pre-enhanced Recovery After Surgery (ERAS) Single Center Assessment

ERAS and Gastrointestinal Site Infections: Insights from a Comprehensive Systematic Review and Meta-Analysis

Exploring the effects of post operative hyperoxic intermittent stimuli on reticulocyte levels in cancer patients: a randomized controlled study

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