Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS®) society recommendations

Cerantola, Yannick; Valério, Massimo; Persson, Beata; Jichlinski, Patrice; Ljungqvist, Olle; Hübner, Martin; Kassouf, Wassim; Müller, Stig; Baldini, Gabriele; Carli, Francesco; Naesheimh, Torvind; Ytrebø, Lars Marius; Revhaug, Arthur; Lassen, Kristoffer; Knutsen, Tore; Aarsether, Erling; Wiklund, Peter; Patel, Hitendra

doi:10.1016/j.clnu.2013.09.014

Cited by 618 publications

(439 citation statements)

References 43 publications

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“…However, it is documented that patient decision aids such as printed documents and online information sources increase the involvement of patients in decision-making process and also increase the value of informed consent [24]. In addition, leaflets or multimedia information regarding the procedure and details of the patients' postoperative tasks improve results of perioperative feeding, mobilization and respiratory physiotherapy, thereby reducing complications after major abdominal surgery [1,19].…”

Section: Preoperative Counselingmentioning

confidence: 99%

“…The ERAS strategy has been validated in colorectal surgery and is applied in other specialties including urology, thoracic, vascular and orthopedic surgery [1][2][3]. In colorectal surgery, ERAS pathways allow significant reduction in postoperative complications, faster functional recovery, shorter hospital stays and reduced costs, even in elderly patients [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus. Methods A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations. Results A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia. Conclusions The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.

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Section: Preoperative Counselingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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“…For instance, in the 2012 guidelines there was an important change in direction recognizing that in laparoscopic colorectal surgery the benefits of thoracic epidural anesthesia (TEA) seen in open colorectal surgery were not directly transferable to laparoscopic surgery. 6 There are now multinational guideline groups developing guidelines across all surgical specialties and so far evidence-based guidelines have been published or are being developed in pancreatectomy, 7 gastric resection, 8 cystectomy, 9 pelvic and rectal surgery, 10 gynecology, and esophagectomy. The spread and adoption of ERPs has been rapid and some centers in the United Kingdom now have ERPs in all elective surgical specialties, and emergency orthopedic and abdominal surgery.…”

Section: Introductionmentioning

confidence: 99%

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Scott

Miller

2015

Anesthesiology Clinics

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KEYWORDSEnhanced recovery pathway Fast-track surgery Anesthesia Perioperative care Pathophysiology of surgery Stress response to surgery Metabolic response to surgery Minimally invasive surgery KEY POINTSEnhanced recovery pathways aim to reduce the stress response and improve the metabolic response to surgery restoring the patient to preoperative function more quickly.It is increasingly recognized that rapid, uncomplicated, recovery reduces not only the cost and length of stay of the patient episode but medical and possibly surgical related complications. Provided defined discharge criteria are met readmission rates are not increased.Minimally invasive surgery is a key component of enhanced recovery to reduce the primary injury of tissue damage and blood loss, which both drive the stress response and metabolic response to surgery.All elements of an enhanced recovery pathway are important because they interact positively with each other, a term likened to the sum of small gains.The anesthesiologist plays a key role in optimizing surgical outcomes by controlling a patient's physiology throughout the perioperative pathway.Anesthesiology Clin 33 (2015) 79-91 http://dx

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“…Indeed there are now consensus guidelines from the ERAS society for patients undergoing upper gastrointestinal surgery, 87 urological surgery, 88 colorectal surgery, 1,8,9 and hepatobiliary and pancreatic surgery. 89 This guidance has resulted in the widespread acceptance of the ERAS principles and adoption of these programmes in surgical units across the UK and Europe.…”

Section: Discussionmentioning

confidence: 99%

Enhanced Recovery after Surgery

Lsmu¹,

klinika²,

nuskausminimas³

et al. 2018

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Enhanced Recovery or Fast Track Recovery after Surgery protocols (ERAS) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery.The present systematic review aimed to examine the impact on the magnitude of the systemic inflammatory response (SIR) for each ERAS component following colorectal surgery using objective markers such as C-reactive protein (CRP) and interleukin-6 (IL-6).A literature search was performed of the US National Library of Medicine (MEDLINE), EMBASE, PubMed, and the Cochrane Database of Systematic Reviews using appropriate keywords and subject headings to February 2015.Included studies had to assess the impact of the selected ERAS component on the SIR using either CRP or IL-6. Nineteen studies, including 1898 patients, were included. Fourteen studies (1246 patients) examined the impact of laparoscopic surgery on the postoperative markers of SIR. Ten of these studies (1040 patients) reported that laparoscopic surgery reduced postoperative CRP. One study (53 patients) reported reduced postoperative CRP using opioidminimising analgesia. One study (142 patients) reported no change in postoperative CRP following preoperative carbohydrate loading. Two studies (108 patients) reported conflicting results with respect to the impact of goal-directed fluid therapy on postoperative IL-6. No studies examined the effect of other ERAS components, including mechanical bowel preparation, antibiotic prophylaxis, thromboprophylaxis, and avoidance of nasogastric tubes and peritoneal drains on markers of the postoperative SIR following colorectal surgery.The present systematic review shows that, with the exception of laparoscopic surgery, objective evidence of the effect of individual components of ERAS protocols in reducing the stress response following colorectal surgery is limited.(Medicine 94(36):e1286)Abbreviations: CRP = C-reactive protein, EA = epidural analgesia, ERAS = Enhanced Recovery After Surgery, IL-6 = interleukin-6, LA = local anaesthetic, LMWH = low molecular weight heparin, MBP = mechanical bowel preparation, NSAID = non-steroidal anti-inflammatory drug, SIR = systemic inflammatory response, TAP = transversus abdominis plane, TNF = tumor necrosis factor.

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Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS®) society recommendations

Cited by 618 publications

References 43 publications

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Pathophysiology of Major Surgery and the Role of Enhanced Recovery Pathways and the Anesthesiologist to Improve Outcomes

Enhanced Recovery after Surgery

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