Implementation of an enhanced recovery after surgery program with robotic surgery in high-risk patients obtains optimal results after colorectal resections

2021 ◽  
Author(s):  
Lidia Cristóbal Poch ◽  
Carmen Cagigas Fernández ◽  
Marcos Gómez-Ruiz ◽  
Marta Ortega Roldán ◽  
Ramón Cantero Cid ◽  
...  
Keyword(s):  
High Risk ◽  
Robotic Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
High Risk Patients ◽  
Risk Patients ◽  
Colorectal Resections

Enhanced Recovery Program in High-Risk Patients Undergoing Colorectal Surgery: Results from the PeriOperative Italian Society Registry

2016 ◽  
Vol 41 (3) ◽  
pp. 860-867 ◽  
Author(s):  
Marco Braga ◽  
◽  
Nicolò Pecorelli ◽  
Marco Scatizzi ◽  
Felice Borghi ◽  
...  
Keyword(s):  
High Risk ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Italian Society ◽  
High Risk Patients ◽  
Enhanced Recovery Program ◽  
Risk Patients ◽  
Recovery Program

scholarly journals Robotic Surgery for Non-Small Cell Lung Cancer Treatment in High-Risk Patients

2021 ◽  
Vol 10 (19) ◽  
pp. 4408
Author(s):  
Carmelina Cristina Zirafa ◽  
Gaetano Romano ◽  
Elisa Sicolo ◽  
Claudia Cariello ◽  
Riccardo Morganti ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
High Risk ◽  
Robotic Surgery ◽  
Lung Resection ◽  
Perioperative Outcomes ◽  
Robotic Assisted ◽  
High Risk Patients ◽  
Operative Complications ◽  
Risk Patients ◽  
Post Operative Complications

Robotic-assisted pulmonary resection has greatly increased over the last few years, yet data on the application of robotic surgery in high-risk patients are still lacking. The objective of this study is to evaluate the perioperative outcomes in ASA III-IV patients who underwent robotic-assisted lung resection for NSCLC. Between January 2010 and December 2017, we retrospectively collected the data of 148 high-risk patients who underwent lung resection for NSCLC via a robotic approach at our institution. For this study, the prediction of operative risk was based on the ASA-PS score, considering patients in ASA III and IV classes as high-risk patients: of the 148 high-risk patients identified, 146 patients were classified as ASA III (44.8%) and two as ASA IV (0.2%). Possible prognostic factors were also analysed. The average hospital stay was 6 days (8–30). Post-operative complications were observed in 87 (58.8%) patients. Patients with moderate/severe COPD developed in 33 (80.5%) cases post-operative complications, while elderly patients in 25 (55%) cases, with a greater incidence of high-grade complications. No difference was observed when comparing the data of obese and non-obese patients. Robotic surgery appears to be associated with satisfying post-operative results in ASA III-IV patients. Both marginal respiratory function and advanced age represent negative prognostic factors. Due to its safety and efficacy, robotic surgery can be considered the treatment of choice in high-risk patients.

scholarly journals Effects of intraoperative goal-directed fluid therapy and restrictive fluid therapy combined with enhanced recovery after surgery protocol on complications after thoracoscopic lobectomy in high-risk patients: study protocol for a prospective randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zheng Guan ◽  
Yanfeng Gao ◽  
Qiao Qiao ◽  
Qiang Wang ◽  
Jingjie Liu
Keyword(s):  
High Risk ◽  
Fluid Therapy ◽  
Enhanced Recovery ◽  
Controlled Trial ◽  
Fluid Infusion ◽  
High Risk Patients ◽  
Thoracoscopic Lobectomy ◽  
Risk Patients ◽  
Goal Directed Fluid Therapy ◽  
Eras Protocol

Abstract Background Acute kidney injury (AKI) is a common complication after thoracoscopic lobectomy in high-risk patients due to insufficient intraoperative infusion. Goal-directed fluid therapy (GDFT) is an individualized fluid infusion strategy; the fluid infusion strategy is adjusted according to the patient’s fluid response. GDFT during operation can reduce the incidence of AKI after major surgery. Enhanced recovery after surgery (ERAS) protocol optimizes perioperative interventions to decrease the postoperative complications after surgery. In ERAS protocol of lobectomy, intraoperative restrictive fluid therapy is recommended. In this study, we will compare the effects of intraoperative GDFT with restrictive fluid therapy combined with an ERAS protocol on the incidence of AKI after thoracoscopic lobectomy in high-risk patients. Methods/design This is a prospective single-center single-blind randomized controlled trial. Two hundred seventy-six patients scheduled for thoracoscopic lobectomy are randomly allocated to receive either GDFT or restrictive fluid therapy combined with an ERAS protocol at a 1:1 ratio. The primary outcome is the incidence of AKI after operation. The secondary outcomes include (1) the incidence of renal replacement therapy, (2) the length of intensive care unit stay after operation, (3) the length of hospital stay after operation, and (4) the incidence of other complications including infection, acute lung injury, pneumonia, arrhythmia, heart failure, myocardial injury after noncardiac surgery, and cardiac infarction. Discussion This is the first study to compare intraoperative GDFT with restrictive fluid therapy combined with an ERAS protocol on the incidence of AKI after thoracoscopic lobectomy in high-risk patients. The hypothesis is that the restrictive fluid therapy is noninferior to GDFT in reducing the incidence of AKI, but restrictive fluid therapy is simpler to apply than GDFT. Trial registration ClinicalTrials.govNCT04302467. Registered on 26 February 2020

Combination of norfloxacin and cisapride in prevention of SBP in high risk patients: A new approach

2001 ◽  
Vol 120 (5) ◽  
pp. A376-A376
Author(s):  
B JEETSANDHU ◽  
R JAIN ◽  
J SINGH ◽  
M JAIN ◽  
J SHARMA ◽  
...  
Keyword(s):  
High Risk ◽  
New Approach ◽  
High Risk Patients ◽  
Risk Patients

1610: High-Risk Patients Undergoing Radical Prostatectomy Today are Less High-Risk than in the Past

2005 ◽  
Vol 173 (4S) ◽  
pp. 436-436
Author(s):  
Christopher J. Kane ◽  
Martha K. Terris ◽  
William J. Aronson ◽  
Joseph C. Presti ◽  
Christopher L. Amling ◽  
...  
Keyword(s):  
High Risk ◽  
Radical Prostatectomy ◽  
High Risk Patients ◽  
The Past ◽  
Risk Patients
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