Enhanced recovery after surgery pathway: association with lower incidence of wound complications and severe hypoalbuminemia in patients undergoing posterior lumbar fusion surgery

Wang, Shuaikang; Wang, Peng; Li, Xiangyu; Sun, Wenzhi; Kong, Chao; Lu, Shibao

doi:10.1186/s13018-022-03070-z

Cited by 8 publications

(6 citation statements)

References 31 publications

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“…Of these articles, 11 are for fracture-related procedures [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. There are 14 articles on joint replacement-related surgery [ 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ] and 15 articles on spine surgery [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. The relevant literature search and exclusion process is shown in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“… ( A ): Risk of bias assessment in studies. ( B ): Risk of bias assessment in each study [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. …”

Section: Figurementioning

confidence: 99%

“… ( A ): The forest plot for joint replacement surgery of VAS. ( B ): The forest plot for spine surgery of VAS [ 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ]. …”

Section: Figurementioning

confidence: 99%

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Enhanced Recovery after Surgery Rehabilitation Protocol in the Perioperative Period of Orthopedics: A Systematic Review

Tao

Yan

Bai

et al. 2023

JPM

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Purpose: Enhanced recovery after surgery (ERAS) is a surgical rehabilitation protocol of increasing interest to clinicians in recent years, with the aim of faster and better recovery of patients after surgery. Our main focus in this review is to analyze the effectiveness of ERAS rehabilitation protocols in orthopedic surgery. By comparing the post-operative recovery of patients receiving the ERAS rehabilitation program with that of patients receiving the conventional rehabilitation program, we observed whether the patients who have received the ERAS rehabilitation program could recover better and faster, thereby achieving the aim of a shorter hospital stay and reducing the incidence of complications. Methods: We conducted the literature searches in PubMed, MEDLINE, Web of Science, Cochrane Reviews, EMBASE and other databases on clinical studies related to orthopedic surgery regarding the effectiveness of rehabilitation using ERAS rehabilitation protocols compared with conventional rehabilitation protocols. A systematic review was performed in accordance with the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. If there was variability in the rehabilitation data of the patients between the two subgroups, it was considered that there was a difference in the rehabilitation effect of the ERAS rehabilitation protocol and the conventional rehabilitation protocol on the patients. Conclusion: The application of ERAS rehabilitation protocols can shorten patients’ hospital stay and reduce their expenses. In addition, patients with ERAS rehabilitation protocols will have fewer postoperative complications, while patients will have less postoperative pain than those with conventional rehabilitation, facilitating better postoperative recovery.

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Section: Resultsmentioning

confidence: 99%

Section: Figurementioning

confidence: 99%

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Enhanced Recovery after Surgery Rehabilitation Protocol in the Perioperative Period of Orthopedics: A Systematic Review

Tao

Yan

Bai

et al. 2023

JPM

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“…Our ERAS strategy substantially facilitated the early recovery of physiological functions and reduced the incidence of postoperative complications after major spine surgery. Previous studies drew inconsistent conclusions regarding the impact of ERAS protocol on complications after major spine surgery [20]. Porche et al [19]and Dagal et al [17]found no differences between the ERAS and Pre-ERAS groups regarding postoperative complications after spinal surgery.…”

Section: Discussionmentioning

confidence: 99%

The implementation of enhanced recovery after surgery pathway in patients undergoing posterior thoracolumbar fusion for degenerative spinal deformity

Yuan¹,

Wang

Chai

et al. 2023

BMC Musculoskelet Disord

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Purpose The prevalence of degenerative spinal deformity (DSD) and the increased cost of correction surgery impose substantial burdens on the health care and insurance system. The aim of our study was to investigate the effects of the implementation of Enhanced Recovery After Surgery (ERAS) protocol on postoperative outcomes after complex spinal surgery. Methods A retrospective analysis of prospectively established database of DSD was performed. The consecutive patients who underwent open correction surgery for degenerative spinal deformity between August 2016 and February 2022 were reviewed. We extracted demographic data, preoperative radiographic parameters, and surgery-related variables. The ERAS patients were 1:1 propensity-score matched to a historical cohort by the same surgical team based on age, gender, BMI, and number of levels fused. We then compared the length of hospital stay (LOS), physiological functional recovery, and the rates of complications and readmissions within 90 days after surgery between the groups. Results There were 108 patients included, 54 patients in the ERAS cohort, and 54 patients matched control patients in the historical cohort. The historical and ERAS cohorts were not significantly different regarding demographic characteristics, comorbidities, preoperative parameters, operative time, and reoperation rate (P > 0.05). Patients in the ERAS group had significantly shorter postoperative LOS (12.0 days vs. 15.1 days, P = 0.001), average days of drain and urinary catheters placement (3.5 days vs. 4.4 days and 1.9 days vs 4.8 days, respectively), and lower 90-day readmission rate (1.8% vs. 12.9%, P = 0.027). The first day of assisted-walking and bowel movement occurred on average 1.9 days (2.5 days vs. 4.4 days, P = 0.001) and 1.7 days (1.9 days vs. 3.6 days, P = 0.001) earlier respectively in the ERAS group. Moreover, the rate of postoperative urinary retention (3.7% vs. 16.7%, P = 0.026) and surgical site infection (0% vs. 7.4%, P = 0.046) were significantly lower with ERAS protocol applied. Conclusions Our study confirmed that the ERAS protocol was safe and essential for patients undergoing thoracolumbar deformity surgery for DSD. The ERAS protocol was associated with a shorter postoperative LOS, a lower rate of 90-day readmission, less rehabilitation discharge, and less postoperative complications.

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“…Balanced postoperative nutrition status relying on adequate enteral intake is important for wound healing. 27,28 Minig et al 29 demonstrated that the traditional diet protocol was associated with a higher wound infection and wound dehiscence rate in patients who underwent gynecologic oncology surgery. Among patients receiving gynecologic oncology surgery with intestinal resection, early-diet protocol still reduced wound infection incidence.…”

Section: Discussionmentioning

confidence: 99%

Early oral diet may enhance recovery from benign gynecologic surgery: A single center prospective study

Yang,

Kuo,

Liu

et al. 2023

Journal of the Chinese Medical Association

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Background: Early dietary intake enhances recovery after surgery (ERAS). There remains a gap in the recognition and implementation of early-diet after surgery in medical institutions in Taiwan. This study aimed to investigate whether early oral intake after benign gynecologic surgery results in favorable outcomes in Taiwanese patients. Methods: This was a prospective controlled non-randomized cohort study. Patients who underwent benign gynecological surgery were included in the early and conventional-diet groups. The primary outcome was length of hospital stay, and the secondary outcome was postoperative complications. Results: Forty and 38 patients in included in the early and conventional-diet groups, respectively. The early-diet group demonstrated significantly reduced length of hospital stay (the early-diet group, 2.58±0.93 days; conventional-diet group, 4.16±1.13 days; p<0.001). No increase in postoperative complications was observed in the early-diet group. Laparoscopic surgery reduced the length of hospital stay (Beta, -0.65; 95%CI, -1.22~ -0.08; p=0.027), while an increased length of hospital stay was associated with higher visual analog scales (VAS, Beta, 0.21; 95%CI, 0.03~ 0.39; p=0.026) and the conventional-diet group (Beta, 1.13; 95%CI, 0.65~ 1.61; p<0.001) as assessed by multivariate regression analysis. Conclusion: Patients who underwent benign gynecologic surgery tolerated an early oral diet well without an increase in complications. Laparoscopic surgery and lower pain scores also enhanced postoperative recovery.

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Enhanced recovery after surgery pathway: association with lower incidence of wound complications and severe hypoalbuminemia in patients undergoing posterior lumbar fusion surgery

Cited by 8 publications

References 31 publications

Enhanced Recovery after Surgery Rehabilitation Protocol in the Perioperative Period of Orthopedics: A Systematic Review

Enhanced Recovery after Surgery Rehabilitation Protocol in the Perioperative Period of Orthopedics: A Systematic Review

The implementation of enhanced recovery after surgery pathway in patients undergoing posterior thoracolumbar fusion for degenerative spinal deformity

Early oral diet may enhance recovery from benign gynecologic surgery: A single center prospective study

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