The introduction of early patient rehabilitation in surgery of soft tissue sarcoma and its impact on post-operative outcome

Michot, Audrey; Stoeckle, Eberhard; Bannel, J.-D.; Colombani, Sylvie; Sargos, P.; Brouste, Véronique; Italiano, Antoîne; Kind, Michèle

doi:10.1016/j.ejso.2015.08.173

Cited by 20 publications

(12 citation statements)

References 25 publications

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“…Patients treated according to the ERAS protocol had lower rates of wound dehiscence and ileus and/or bowel obstruction, were less likely to be discharged to a facility, and had a shorter median hospital stay by 1 day. A previous study 10,11 of ERAS in the setting of STS showed that implementation of the protocol reduced hospital stay but with no significant reduction in major morbidity 11 . That study was limited to patients with extremity and trunk STS.…”

Section: Discussionmentioning

confidence: 98%

“…Similar results have been reported for hepatobiliary, gastric, oesophageal, thoracic, urological, gynaecological, orthopaedic and emergency surgery 1 . Studies of the implementation of ERAS protocols for patients with soft tissue sarcoma (STS) are limited, with published reports focused on extremity/trunk STS 10 . The aim of this study was to evaluate an ERAS protocol specifically tailored to patients undergoing surgery for STS.…”

Section: Introductionmentioning

confidence: 99%

“…Studies of the implementation of ERAS protocols for patients with soft tissue sarcoma (STS) are limited, with published reports focused on extremity/trunk STS 10 . The aim of this study was to evaluate an ERAS protocol specifically tailored to patients undergoing surgery for STS.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Lyu

Saadat

Bertagnolli

et al. 2020

British Journal of Surgery

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Background: Patients undergoing surgery for soft tissue sarcoma have high morbidity rates, particularly after preoperative radiation therapy (RT). An enhanced recovery after surgery (ERAS) programme may improve perioperative outcomes in abdominal surgery. This study reported outcomes of an ERAS programme tailored to patients with soft tissue sarcoma. Methods: A prospective ERAS protocol was implemented in 2015 at a high-volume sarcoma centre. Patients treated within the ERAS programme from 2015 to 2018 were case-matched retrospectively with patients treated between 2012 and 2018 without use of the protocol, matched by surgical site, surgeon, sarcoma histology and preoperative RT treatment. Postoperative outcomes, specifically wound complications and duration of hospital stay, were reported. Results: In total, 234 patients treated within the ERAS programme were matched with 237 who were not. The ERAS group had lower wound dehiscence rates overall (2 of 234 (0⋅9 per cent) versus 31 of 237 (13⋅1 per cent); P < 0⋅001), after preoperative RT (0 of 41 versus 11 of 51; P = 0⋅004) and after extremity sarcoma surgery (0 of 54 versus 6 of 56; P = 0⋅040) compared with the non-ERAS group. Rates of postoperative ileus or obstruction were lower in the ERAS group (21 of 234 (9⋅9 per cent) versus 40 of 237 (16⋅9 per cent); P = 0⋅016) and in those with retroperitoneal sarcoma (4 of 36 versus 15 of 36; P = 0⋅007). Duration of hospital stay was shorter in the ERAS group (median 5 (range 0-36) versus 6 (0-67) days; P = 0⋅003). Conclusion: Treatment within an ERAS protocol for patients with soft tissue sarcoma was associated with lower morbidity and shorter hospital stay.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Lyu

Saadat

Bertagnolli

et al. 2020

British Journal of Surgery

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“…One way to potentially reduce the length of stay is through the introduction of an early patient rehabilitation protocol. 18 In the series by Michot et al, 18 the authors noted a significant reduction in the hospital length of stay in a series of patients with soft-tissue sarcomas by introducing a rapid recovery rehabilitation program. Although the current series examines patients with bone sarcomas, the utilization of a rapid recovery pathway for these patients could also reduce the hospitalization stay for these patients.…”

Section: Discussionmentioning

confidence: 99%

What are the predictors of emergency department utilization and readmission following extremity bone sarcoma resection?

Wellings

Wagner

Wilke

et al. 2020

Journal of Surgical Oncology

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Introduction: Treatment for bone sarcomas are large undertakings. Emergency department (ED) visits and unplanned hospital readmissions are a potential target for cost containment. The purpose of this study was to evaluate the risk factors for ED visits and unplanned readmissions following extremity bone sarcoma surgery. Methods: Data from Optum Labs Data Warehouse, a national administrative claims database, was analyzed to identify patients with extremity bone sarcomas from 2006 to 2017. Multivariable logistic regression was used to identify factors associated with ED visits and readmissions. Results: Of 1390 (743 males, 647 female) adult patients, 137 (12%) visited the ED and 245 (18%) were readmitted within 30 days of discharge. The most common indication for ED visits (n = 63, 45.9%) and readmission (n = 119, 48.5%) were complications of surgery. Length of stay >10 days was associated with ED utilization (OR, 1.83; P = .01) and readmission (OR, 4.47; P < .001). Conclusion: One in ten patients will use the ED, and one in five patients will be readmitted to the hospital within 30 days of discharge following extremity bone sarcoma surgery. Length of stay was associated with ED visits and readmission. These patients could be targeted with alternative management strategies in the outpatient setting with early clinical follow-up to minimize readmission.

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“…39 Alguns estudos em cirurgias colorretais, ortopédicas, vasculares e em alguns procedimentos torácicos, já demonstraram como benefícios da reabilitação precoce a redução das taxas de morbidade, de complicações pós-operatórias e de tempo de internação hospitalar. 18,34,40,41,42,43 Porém, estes resultados não refletem de forma específica a funcionalidade dos pacientes no momento da alta hospitalar, e, para o nosso conhecimento, não há programa de reabilitação formal para os pacientes com PE submetidos a correção cirúrgica, e nenhum outro estudo realizou a reabilitação precoce nestes pacientes.…”

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Capacidade funcional de exercício e função pulmonar em pacientes submetidos a um programa de reabilitação precoce após técnica de Nuss: um estudo controlado randomizado

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Capacidade funcional de exercício e função pulmonar em pacientes submetidos a um programa de reabilitação precoce após técnica de Nuss: um estudo controlado randomizado São Paulo 2016 DedicatóriaAos meus pais, Moisés e Altair, por acreditarem em mim mais do que eu mesma e pelos sacrifícios realizados em razão dos meus sonhos e dos sonhos dos meus irmãos.Aos meus irmãos Marcus, Moisés e Diego, por trazerem tantas alegrias a minha vida e por fazerem de mim uma pessoa melhor.Ao meu esposo Thiago, por ser um dos motivos para concretização deste estudo, por tudo que representa na minha vida e por ser meu exemplo de força e determinação. Esta conquista é nossa!! Amo vocês!! AgradecimentosA Deus, por tantas graças alcançadas.Aos meus pais, por me ensinarem o valor do amor em família, do respeito para com todos, a importância da eterna aprendizagem e que temos sempre que lutar pelos nossos objetivos. Muito obrigada!! Aos meus irmãos, pelo cuidado, proteção, companheirismo, amor, por tantos momentos divididos e por sempre me apoiarem em todas as fases da minha vida.Ao meu esposo Thiago, pelo amor, carinho, incentivo e paciência, pelas sugestões e críticas, por não me deixar desanimar e por estar sempre ao meu lado.Aos meus sogros, Tarcísio e Rosana, pela calorosa acolhida na sua família, pelo carinho, apoio e torcida.As amigas Mariana e Majana, que aceitaram junto comigo vir a São Paulo.A amiga Priscila Ramos, por tantas batalhas enfrentadas para conseguirmos a pós-graduação, pela ajuda e companheirismo.Ao Prof. Dr. João Carlos das Neves Pereira, por abrir as portas para o início desta jornada, pelos ensinamentos científicos e humanos, e por me mostrar o caminho a seguir.À Dra. Rosângela Monteiro, pela disponibilidade, ajuda, sugestões e orientações tão importantes para a realização deste estudo.Ao Prof. Dr. José Ribas Milanez de Campos, pela acolhida num momento de muitas mudanças e por permitir a realização deste estudo. Obrigada pela oportunidade.Aos pacientes que aceitaram participar deste estudo, por se colocarem a disposição da ciência.A equipe de enfermagem do centro cirúrgico e da unidade de internação do 8º andar e ao escriturário Rafael, pela ajuda indispensável na coleta de dados.A Juliana Lattari Sobrinho, Neusa Rodrigues, Tatiane Lago, Mônica Souto da Secretaria da Pós-Graduação, pela colaboração constante em todos os aspectos burocráticos.Aos amigos construídos, Laura, Natália, Thales, Aída, Aristides e Karina Andrighetti, pela ajuda, sugestões e por tornar a pós-graduação mais agradável.

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The introduction of early patient rehabilitation in surgery of soft tissue sarcoma and its impact on post-operative outcome

Cited by 20 publications

References 25 publications

Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

What are the predictors of emergency department utilization and readmission following extremity bone sarcoma resection?

Capacidade funcional de exercício e função pulmonar em pacientes submetidos a um programa de reabilitação precoce após técnica de Nuss: um estudo controlado randomizado

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