Fast-track vs standard care in colorectal surgery: a meta-analysis update

Gouvas, Nikolaos; Tan, Ek Khoon; Windsor, Alastair; Xynos, Evaghelos; Tekkis, Paris

doi:10.1007/s00384-009-0703-5

Cited by 264 publications

(209 citation statements)

References 37 publications

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“…Although growing evidence from several RCTs, systematic reviews and meta-analyses suggest significant benefits from ERAS pathways, there are still major difficulties when introducing these evidence-based guidelines into routine practice. 9,84,87 The fact that less than half of patients are involved in a postoperative care pathway suggests that perioperative care continues to resemble traditional and conventional attitudes. 88,89 Many surgeons state that they have "never heard of ERAS," while others cite inadequate multidisciplinary and community support as an impediment to implementation.…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

275

120

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Radical cystectomy with pelvic lymph node dissection remains the standard treatment for patients with muscle invasive bladder cancer. Despite improvements in surgical technique, anesthesia and perioperative care, radical cystectomy is still associated with greater morbidity and prolonged in-patient stay after surgery than other urological procedures. Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response following surgery. The key elements of ERAS protocols include preoperative counselling, optimization of nutrition, standardized analgesic and anesthetic regimens and early mobilization. Despite the significant body of evidence indicating that ERAS protocols lead to improved outcomes, they challenge traditional surgical doctrine, and as a result their implementation has been slow.The present article discusses particular aspects of ERAS protocols which represent fundamental shifts in surgical practice, including perioperative nutrition, management of postoperative ileus and the use of mechanical bowel preparation.

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Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) protocols: Time to change practice?

Melnyk

Casey

Black

et al. 2013

CUAJ

275

120

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“…Randomised studies showed a reduction in hospital days without compromising the safety of the patients, with a lower morbidity and a readmission rate similar to the one of colonic surgery with conventional care [14].…”

Section: Introductionmentioning

confidence: 89%

Enhanced Recovery After Surgery (ERAS) Implementation of a Protocol in Laparoscopic Colectomy, Initial Experience in a Single Institution in Argentina

Uriburu¹

2016

GHOA

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“…Studies of fast track general surgery rarely include cost analyses 2,16,17 . Clinical outcomes speak in favor of cost-effectiveness even though no analyses have previously been presented.…”

Section: Commentmentioning

confidence: 99%