Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review

El-Kefraoui, Charbel; Do, Uyen; Miller, Andrew C.; Kouyoumdjian, Araz; Cui, David; Khorasani, Elahe; Landry, Tara; Amar‐Zifkin, Alexandre; Lee, Lawrence; Feldman, Liane S.; Fiore, Julio F.

doi:10.1007/s00464-023-10289-2

Cited by 7 publications

(2 citation statements)

References 84 publications

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“…There were no significant Clavien-Dindo grade III or above morbidities, readmissions within 30 days of discharge nor 90-day mortality demonstrating the feasibility and safety of robotic day-case liver resection. With shorter length of stay and enhanced recovery, not only are there cost-saving benefits, but reduced length of stay has a positive impact on the patient's physical recovery and mental well-being in the post-operative period [22].…”

Section: Discussionmentioning

confidence: 99%

Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre

Yeung,

Vellaisamy,

Hussain

et al. 2024

Surg Endosc

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Background Liver surgery is associated with a significant hospital stay regardless the type of liver resection. A large incision is essential for open liver surgery which is a major factor in the course of the patient’s recovery. For patients with small parenchyma liver lesions requiring surgical resection, robotic surgery potentially offers the opportunity to transform the patient’s post-operative course. A day-case robotic liver resection pathway was formulated and implemented at our institution when patients were planned for discharge within 24 h of admission for liver surgery. Methods Single surgeon case series of cases performed at a tertiary hepatobiliary and pancreatic centre between September 2022 and November 2023. The inclusion criteria were non-anatomical wedge resections, < 2 anatomical segmental resections, left lateral hepatectomy and minimally invasive surgery. Results This is the first series of robotic day-case minor liver resection in the United Kingdom. 20 patients were included in this case series. The mean operative time was 86.6 ± 30.9 min and mean console time was 58.6 ± 24.5 min. Thirteen patients (65%) were discharged within 24 h of surgery. The main cause of hospitalisation beyond 24 h was inadequate pain relief. There were no Clavien–Dindo grade III or above complications, no 30-day readmission and 90-day mortalities. Conclusion This case series demonstrates that robotic day-case liver resection is safe and feasible. Robust follow-up pathways must be in place to allow for the safe implementation of this approach, to monitor for any complications and to allow intervention as required in a timely manner.

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Section: Discussionmentioning

confidence: 99%

Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre

Yeung,

Vellaisamy,

Hussain

et al. 2024

Surg Endosc

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“…Abdominal surgery accounts for a relatively high proportion of in-hospital operations and causes a heavy healthcare burden (El-Kefraoui et al, 2023). Because the incision is close to the diaphragm and the abdominal region has a dense neuronal network, patients following abdominal surgery generally have severe pain (Koyuncu & Iyigun, 2022).…”

Section: Backg Rou N Dmentioning

confidence: 99%

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Wang,

Qin,

Zhen

et al. 2024

Journal of Clinical Nursing

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AimsTo develop a nomogram to provide a screening tool for recognising patients at risk of post‐operative pain undergoing abdominal operations.BackgroundRisk prediction models for acute post‐operative pain can allow initiating prevention strategies, which are valuable for post‐operative pain management and recovery. Despite the increasing number of studies on risk factors, there were inconsistent findings across different studies. In addition, few studies have comprehensively explored predictors of post‐operative acute pain and built prediction models.DesignA prospective observational study.MethodsA total of 352 patients undergoing abdominal operations from June 2022 to December 2022 participated in this investigation. A nomogram was developed for predicting the probability of acute pain after abdominal surgery according to the results of binary logistic regression. The nomogram's predictive performance was assessed by discrimination and calibration. Internal validation was performed via Bootstrap with 1000 re‐samplings.ResultsA total of 139 patients experienced acute post‐operative pain following abdominal surgery, with an incidence of 39.49%. Age <60, marital status (unmarried, divorced, or widowed), consumption of intraoperative remifentanil >2 mg, indwelling of drainage tubes, poor quality sleep, high pain catastrophizing, low pain self‐efficacy, and PCIA not used were predictors of inadequate pain control in patients after abdominal surgery. Using these variables, we developed a nomogram model. All tested indicators showed that the model has reliable discrimination and calibration.ConclusionsThis study established an online dynamic predictive model that can offer an individualised risk assessment of acute pain after abdominal surgery. Our model had good differentiation and calibration and was verified internally as a useful tool for risk assessment.Relevance to Clinical PracticeThe constructed nomogram model could be a practical tool for predicting the risk of experiencing acute post‐operative pain in patients undergoing abdominal operations, which would be helpful to realise personalised management and prevention strategies for post‐operative pain.Reporting MethodThe Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.Patient or Public ContributionBefore the surgery, research group members visited the patients who met the inclusion criteria and explained the purpose and scope of the study to them. After informed consent, they completed the questionnaire. The patients' pain scores (VAS) were regularly assessed and documented by the bedside nurse for the first 3 days following surgery. Other information was obtained from medical records.

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Association between patient activation and adherence to a colorectal enhanced recovery pathway: a prospective cohort study

Al Ben Ali,

Fermi,

Olleik

et al. 2024

Surg Endosc

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Impact of enhanced recovery pathways on patient-reported outcomes after abdominal surgery: a systematic review

Cited by 7 publications

References 84 publications

Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre

Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre

Development of a nomogram for predicting acute pain among patients after abdominal surgery: A prospective observational study

Association between patient activation and adherence to a colorectal enhanced recovery pathway: a prospective cohort study

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