Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations

Gustafsson, Ulf; Scott, Michael J.; Schwenk, W.; Demartines, Nicolas; Roulin, Didier; Francis, Nader; McNaught, Clare; MacFie, John; Liberman, Alexander; Soop, Mattias; Hill, Andrew; Kennedy, R. H.; Lobo, Dileep N.; Fearon, Kenneth C. H.; Ljungqvist, Olle

doi:10.1016/j.clnu.2012.08.013

Cited by 804 publications

(758 citation statements)

References 228 publications

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“…Recommendation: Patients at risk (weight loss [10-15 % within 6 months, BMI \ 18.5 kg/m 2 , and Preoperative fasting no more than 2 h for liquids and 6 h for solid food has proven to be safe and is recommended for digestive surgery [32]. A recent systematic review included 17 randomized trials with 1445 surgical patients [33].…”

Section: Perioperative Nutritionmentioning

confidence: 99%

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: Perioperative Nutritionmentioning

confidence: 99%

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

et al. 2016

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“…All recommendations by ERAS society for colonic surgery (see also: http://www.erassociety.org/index.php/eras-care-system/eras-protocol) can potentially be implemented in gastric cancer patients, i.e., early removal of urinary catheter, prevention of postoperative ileus, postoperative analgesia, and early mobilization and resumption of normal diet [100] . Important to note is that ERAS protocols not only include recommendations on postoperative care, but also preoperative measures (e.g., counseling) and intra-operative measures (e.g., avoidance of salt and water overload and use of short acting anesthetic agents).…”

Section: Advances In Postoperative Carementioning

confidence: 99%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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“…Since September 2013, our institute revised our pain management following LG from 48 hours of epidural anesthesia to 24 hours of intravenous fentanyl and 4 days of oral celecoxib, because we consider that the analgesic effect of epidural anesthesia is not necessarily needed for patients requiring LG and could be replaced with non-steroidal anti-inflammatory drugs (NSAIDs), which play an important role in analgesia following colorectal surgery [15]. Here we aimed to evaluate the efficacy of this new analgesic protocol on postoperative pain in a retrospective comparative study.…”

Section: Introductionmentioning

confidence: 99%

A comparison between fentanyl plus celecoxib therapy and epidural anesthesia for postoperative pain management following laparoscopic gastrectomy

et al. 2015

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Purpose To clarify the efficacy of postoperative pain management following laparoscopic gastrectomy (LG), we retrospectively compared pain assessments in patients who received fentanyl plus celecoxib with those who received epidural anesthesia. Results No significant difference in the severity of postoperative pain on postoperative day (POD) 0 or 1 was observed between the two groups. In contrast, pain was significantly lower in Group-FC than Group-E on POD 2, 3, 4, and 7. The total use of rescue pain medications during the first 7 days following LG did not differ between the two groups. Methods ConclusionPain management using 24 hours of intravenous fentanyl and 4 days of oral celecoxib is comparable to epidural anesthesia following LG.

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Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations

Cited by 804 publications

References 228 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

Improving the outcomes in gastric cancer surgery

A comparison between fentanyl plus celecoxib therapy and epidural anesthesia for postoperative pain management following laparoscopic gastrectomy

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