PROFAST: A randomised trial implementing enhanced recovery after surgery for highcomplexity advanced ovarian cancer surgery

Sánchez-Iglesias, José Luís; Carbonell-Socias, Melchor; Pérez-Benavente, Mª Assumpció; Clua, Sonia Monreal; Manrique-Muñoz, Susana; Gorriz, Manel García; Burgos-Peláez, Rosa; Gurrutxaga, Hegoi Segurola; Serrano, Mónica Pamies; Gutiérrez-Barceló, Ma Del Pilar; Serrano-Castro, Susana; Balcells-Farré, Ma Teresa; Pérez-Barragán, Carmen; Scaillet-Houberechts, Axelle; Cossio-Gil, Yolima; Gil‐Moreno, Antonio

doi:10.1016/j.ejca.2020.06.011

Cited by 49 publications

(67 citation statements)

References 37 publications

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“…However, sustainment should not be entertained within AHS until at least an overall adherence of 75% to 80% is achieved; therefore, more frequent ERAS team meetings are required to review ERAS adherence and outcomes combined with PDSA cycles targeted at problem areas of low adherence. 28 The overall adherence in the ERAS gynecologic oncology cohort was 75%. This was associated with an LOS reduction of 0.6 days overall, with the findings most pronounced in the high-complexity (debulking) group in which a 1.…”

Section: Jama Network Open | Surgerymentioning

confidence: 98%

Evaluation of the Implementation of Multiple Enhanced Recovery After Surgery Pathways Across a Provincial Health Care System in Alberta, Canada

et al. 2021

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IMPORTANCE Engaging multidisciplinary care teams in surgical practice is important for the improvement of surgical outcomes. OBJECTIVE To evaluate the association of multiple Enhanced Recovery After Surgery (ERAS) pathways with ERAS guideline adherence and outcomes. DESIGN, SETTING, AND PARTICIPANTS This quality improvement study compared a pre-ERAS cohort (2013-2017) with a post-ERAS cohort (2014-2018). All patients were from Alberta Health Services in Alberta, Canada, and had available ERAS and up to 1-year postsurgery administrative data. Data collected included age, sex, body mass index, tobacco and alcohol use, diabetes, comorbidity index, and surgical characteristics. Data analysis was performed from May 7, 2020, to February 1, 2021. INTERVENTIONS Implementation of 5 ERAS pathways (colorectal, liver, pancreas, gynecologic oncology, and radical cystectomy) across 9 sites. MAIN OUTCOMES AND MEASURES Adherence to ERAS guidelines was measured by the percentage of patients whose care met the common ERAS pathway care element criteria. Surgical procedures were grouped by complexity; complications were classified by severity. Outcome measures for the pre-post-ERAS cohorts included length of stay (LOS), readmission, complications, and mortality. RESULTS A total of 7757 patients participated in the study, including 984 in the pre-ERAS cohort

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Section: Jama Network Open | Surgerymentioning

confidence: 98%

Evaluation of the Implementation of Multiple Enhanced Recovery After Surgery Pathways Across a Provincial Health Care System in Alberta, Canada

et al. 2021

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“…Moreover, goal directed fluid therapy, recommended in the ERAS protocol, does not define fluid balance. A recent phase III trial demonstrated a reduction in both length of stay and readmissions in favour of the ERAS protocol vs conventional perioperative management in women with advanced ovarian cancer, however there was no difference in postoperative complications [35].…”

Section: Discussionmentioning

confidence: 99%

Perioperative fluid balance and major postoperative complications in surgery for advanced epithelial ovarian cancer

Hasselgren

Hertzberg

Camderman

et al. 2021

Gynecologic Oncology

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Objective. Appropriate fluid balance in the perioperative period is important as both hypo-and hypervolemia are associated with increased risk of complications. Women undergoing cytoreductive surgery (CRS) for advanced epithelial ovarian cancer (EOC) may have major fluid shifts. The optimal perioperative fluid balance in these women is yet to be determined. Our objective was to investigate the association between perioperative fluid balance and major postoperative complications.Methods.

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“…In addition, prehabilitation programs and enhanced recovery after surgery (ERAS) protocols have been shown to improve the complication rate and shorten the hospital stay of gynecological cancer patients ( 41 ). A recent random trial implementing ERAS for high-complexity advanced ovarian cancer surgery suggested that ERAS should be used as a standard practice for all cytoreductive surgeries against peritoneal carcinomatosis ( 42 ). In light to this notion, the effect of ERAS on the nutritional status of these patients needs to explored in the future to better understand the mechanism of this treatment.…”

Section: Discussionmentioning

confidence: 99%

Total Parenteral Nutrition Treatment Improves the Nutrition Status of Gynecological Cancer Patients by Improving Serum Albumin Level

et al. 2022

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BackgroundMalnutrition is often observed in gynecological cancer patients, however its prevalence in these patients remains largely unexplored. Total parenteral nutrition (TPN) is a nutritional intervention method that has controversial treatment outcome on gynecological cancer patients. The present retrospective study is designed to evaluate the nutrition status and TPN treatment outcome on patients diagnosed with endometrial, cervical or ovarian malignant tumors.MethodsMedical records of a total of 263 patients treated at the First Hospital of Shanxi Medical University, China were included. Nutrition status was assessed by patient-generated subjective global assessment (PG-SGA). Patients were grouped based on nutrition status, cancer type or treatment strategy for clinical characteristic comparison. Multivariable logistic regression analysis was used to identify predictors for malnutrition status and hospital stay duration.ResultsPresence of endometrial and cervical cancer, body weight before nutritional intervention and serum albumin level (P < 0.001 for all) were found to be significant predictors for malnutrition status in gynecological cancer patients. In the malnourished patients, those who were treated with TPN had significantly lower serum albumin levels before and after treatment (P < 0.001) and PG-SGA scores after treatment. Also, TPN treatment could significantly increase the serum albumin levels in these patients after 1 week. In addition, shorter hospitalization period was needed for TPN-treated endometrial (P = 0.019) and ovarian (P < 0.001) patients. Moreover, serum albumin levels (P < 0.001), use of TPN treatment (P = 0.025) and nutrition status (P = 0.010) were identified to be independent predictors for hospital stay duration.ConclusionOur results suggest that malnutrition is a significant clinical manifestation in gynecological cancer patients who may benefit from TPN treatment for reduced hospitalization and improved serum albumin levels.

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PROFAST: A randomised trial implementing enhanced recovery after surgery for highcomplexity advanced ovarian cancer surgery

Cited by 49 publications

References 37 publications

Evaluation of the Implementation of Multiple Enhanced Recovery After Surgery Pathways Across a Provincial Health Care System in Alberta, Canada

Evaluation of the Implementation of Multiple Enhanced Recovery After Surgery Pathways Across a Provincial Health Care System in Alberta, Canada

Perioperative fluid balance and major postoperative complications in surgery for advanced epithelial ovarian cancer

Total Parenteral Nutrition Treatment Improves the Nutrition Status of Gynecological Cancer Patients by Improving Serum Albumin Level

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