Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis

Pisarska, Magdalena; Małczak, Piotr; Major, Piotr; Wysocki, Michał; Budzyński, Andrzej; Pędziwiatr, Michał

doi:10.1371/journal.pone.0174382

Cited by 93 publications

(64 citation statements)

References 33 publications

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“…These studies were initially met with skepticism as critics questioned inherent selection bias. However, this has now been corroborated by other studies, especially after the addition of laparoscopic surgery . Coyle et al implemented an ERAS protocol for head and neck cancer patients at their institution in the UK .…”

Section: Discussionmentioning

confidence: 77%

Enhanced recovery after surgery in head and neck surgery: Reduced opioid use and length of stay

et al. 2019

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Objectives: Enhanced recovery after surgery (ERAS) protocols were first developed in colorectal surgery and sought to standardize patient care. There have been several studies in the head and neck surgical literature looking at outcomes after ERAS protocol, but no studies focusing on narcotic use and length of stay. This study aimed to evaluate narcotic usage and length of stay, in addition to several other outcomes, following the implementation of an ERAS protocol.Methods: A head and neck-specific ERAS protocol was implemented at this tertiary care center beginning July 2017. A retrospective cohort study was performed comparing this cohort to that of a retrospective control group. Outcomes included mean morphine equivalent dose, mean pain score, and percentage of patients prescribed narcotics on discharge. Secondary outcomes included ICU and total length of stay.Results: The mean morphine equivalent dose (MED) administered within 72 hours postoperatively was significantly lower in the ERAS group (17.5 AE 46.0 mg vs. 82.7 AE 116.1 mg, P < .001). Average postoperative pain scores in the first 72 hours were lower in the ERAS group (2.6 AE 1.8 vs. 3.6 AE 1.9; P < .001). The average length of stay was shorter for ERAS patients (7.8 AE 4.8 vs. 9.7 AE 4.7 days, P = .008); however, there was no significant difference in ICU length of stay.Conclusion: Following implementation of an ERAS protocol, patients undergoing head and neck surgery had decreased narcotic use in the immediate postoperative period and at discharge, while also demonstrating improved postoperative analgesia.

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Section: Discussionmentioning

confidence: 77%

Enhanced recovery after surgery in head and neck surgery: Reduced opioid use and length of stay

et al. 2019

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“…Importantly, especially among elderly people, perioperative care appears to play a crucial role in improving postoperative outcomes. Recent developments in perioperative care and introduction of enhanced recovery after surgery (ERAS) protocols in bariatric surgery and other surgical disciplines have led to faster recovery and reduction in postoperative morbidity [27][28][29]. The ERAS protocols have enabled elimination of some of the traditional risk factors for postoperative complications and prolonged length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study.

Dowgiałło-Wnukiewicz

Janik

Lech

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: The prevalence of obesity is increasing according to the World Health Organization. Furthermore, global aging is increasing, especially in developed countries in Europe. Whether bariatric surgery should be performed in elderly people is still controversial. Aim: To determine the clinical outcomes of sleeve gastrectomies (SG) in older central European patients. We compared the safety and efficacy of SG in patients older than 60 years with younger patients. Material and methods: Eighty-nine patients older than 60 years, who underwent SG, were included in the study. Eighty-nine younger patients (aged 18-40 years) were matched according to body mass index (BMI) and comorbidities. The analyzed data included age, sex, total body weight, BMI, length of hospital stay, 30-day complications and improvement in comorbidities. Results: There was no significant difference in the complication rate between the 2 age groups (p = 0.59). An improvement in hypertension was observed in 73.1% of older patients and in 69.2% of younger patients (p = 0.67). There was improvement in diabetes mellitus in 40% of older patients and in 31.1% of younger patients (p = 0.25). The ΔBMI after 12, 24 and 36 months was significantly lower in older patients than in younger patients (p = 0.002, p = 0.001; p = 0.043, respectively). Percent excess BMI loss (%EBMIL) after 12, 24, and 60 months was significantly lower in older than in younger patients (p = 0.001, p = 0.001, p = 0.028, respectively). Conclusions: Better weight loss is achieved in younger than in older patients, while maintaining a similar effect on the risk of complications and improvement in comorbidities. Therefore, SG is safe and effective in older people.

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“…Karaciğer cerrahisi için önerilen ERAS kılavuzu, mevcut en iyi kanıtlara dayanmakla beraber, daha fazla araştırmalara gereksinim duyulmaktadır. Yüksek morbidite ve mortaliteye sahip özofajektomiler için de ERAS kılavuzunun uygulanabilirliğini ve güvenirliğini araştıran çalışmalar da mevcuttur (124,125) .…”

Section: Sonuçlarunclassified

The Enhanced Recovery After Surgery (ERAS) Protocol Implementations in Non-Colorectal Gastrointestinal Surgical Procedures; Bariatric, Hepatobiliary, Pancreaticoduodenectomy, Gastrectomy

Kalaycı¹,

Dagistanli²,

Kara³

2018

IKSST

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Kolorektal cerrahi ile başlayan ERAS uygulamalarında modern hasta bakımı yaklaşımı ile sağlanan ümit verici gelişmeler laparoskopiden, bariatrik cerrahiye, hepatikopankreatik cerrahi girişimlerden meme rekonstrüksiyonuna uzanmıştır. ERAS uygulamaları geleneksel yaklaşımın kanıta dayalı değerlendirmelerle ölçülmesi, örneklenmesi ve öğreti yoluyla hasta ve sağlık uygulayıcılarının yeniden deneyimlediği bakım sürecinin kontrolünü sağlamıştır. Tüm disiplinlerde daha kısa yatış süreleri elde edilirken, disiplin ayrıcalıklı yeni yaklaşım modaliteleri de gelişmiştir. Bariatrik cerrahide operasyon öncesi kilo kontrolü, alkolsigara kullanımı kısıtlamaları, sıvı ve solunum fizyolojisine yaklaşım farklılıkları, meme cerrahisinde opioid kullanımının azaltılması, pankreas tümörlerindeki girişimlerde biliyer drenaj gereksiniminin değerlendirilmesi vb. gibi farklılıkları getirmiştir. Hâlen tüm genel cerrahi disiplinlerde sürecin kontrolü ve sorgulanması amacıyla yeni metodoloji ve uygulamaların değerlendirildiği çalışmalara gereksinim vardır.

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Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis

Cited by 93 publications

References 33 publications

Enhanced recovery after surgery in head and neck surgery: Reduced opioid use and length of stay

Enhanced recovery after surgery in head and neck surgery: Reduced opioid use and length of stay

Outcomes of sleeve gastrectomy in patients older than 60 years: a multicenter matched case-control study.

The Enhanced Recovery After Surgery (ERAS) Protocol Implementations in Non-Colorectal Gastrointestinal Surgical Procedures; Bariatric, Hepatobiliary, Pancreaticoduodenectomy, Gastrectomy

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