Enhanced Recovery After Emergency Surgery

Author(s):  
Madan K ◽  
Tanvi Sahni
2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Caroline Gronnier ◽  
Fabian Grass ◽  
Christiane Petignat ◽  
Basile Pache ◽  
Dieter Hahnloser ◽  
...  

Background. The present study aimed to evaluate a potential effect of ERAS on surgical site infections (SSI). Methods. Colonic surgical patients operated between May 2011 and September 2015 constituted the cohort for this retrospective analysis. Over 100 items related to demographics, surgical details, compliance, and outcome were retrieved from a prospectively maintained database. SSI were traced by an independent National surveillance program. Risk factors for SSI were identified by univariate and multinomial logistic regression. Results. Fifty-four out of 397 patients (14%) developed SSI. Independent risk factors for SSI were emergency surgery (OR 1.56; 95% CI 1.09–1.78, p=0.026), previous abdominal surgery (OR 1.7; 95% CI 1.32–1.87, p=0.004), smoking (OR 1.71; 95% CI 1.22–1.89, p=0.014), and oral bowel preparation (OR 1.86; 95% CI 1.34–1.97, p=0.013), while minimally invasive surgery (OR 0.3; 95% CI 0.16–0.56, p<0.001) protected against SSI. Compliance to ERAS items of >70% was not retained as a protective factor for SSI after multivariate analysis (OR 0.94; 95% CI 0.46–1.92, p=0.86). Conclusions. Smoking, open and emergency surgery, and bowel preparation were risk factors for SSI. ERAS pathway had no independent impact while minimally invasive approach did. This study was registered under ResearchRegistry.com (UIN researchregistry2614).


Author(s):  
Bakarne Ugarte-Sierra ◽  
Aitor Landaluce-Olavarria ◽  
Isaac Cabrera-Serna ◽  
Xavier Viñas-Trullen ◽  
Carlo Brugiotti ◽  
...  

2021 ◽  
pp. 269-274
Author(s):  
Ugo Elmore ◽  
Andrea Vignali ◽  
Giulia Maggi ◽  
Roberto Delpini ◽  
Riccardo Rosati

Chirurgia ◽  
2017 ◽  
Vol 112 (5) ◽  
pp. 546 ◽  
Author(s):  
Mihai Paduraru ◽  
Luca Ponchietti ◽  
Isidro Martinez Casas ◽  
Peter Svenningsen ◽  
Jorge Pereira ◽  
...  

HPB Surgery ◽  
1991 ◽  
Vol 3 (3) ◽  
pp. 167-176 ◽  
Author(s):  
Aws S. Salim

Distension of the gallbladder and bacterial infection can perpetuate an attack of acute calculous cholecystitis and produce its local and systemic complications. This prospective randomized trial was conducted on patients with their first episode of acute calculous cholecystitis which was associated with pyrexia and tachycardia to examine whether ultrasound guided percutaneous aspiration and lavage of the gallbladder followed by intra-lumenal instillation of 500 mg ampicillin (PALA) enhanced recovery from cholecystitis. Twenty patients were randomized to receive 500 mg of ampicillin every 6 hours for 5 days and another 20 patients were randomized to receive this treatment in addition to PALA within 12 hours of admission. Twenty four hours after admission to hospital, all the patients treated with PALA were apyrexial and had no residual right hypochondrial tenderness or guarding, a result superior (p < 0.001) to that of the group without PALA where at least 75% of patients were still showing these signs. Two days after admission the WBC count of the PALA group was significantly (p < 0.05) lower than that of the other group (6.32 ± 0.1 × 109/L vs 10.31 ± 0.4 × 109/L, mean ± SEM, n = 20). Four days after admission, all members of the PALA group were comfortably tolerating solid food for the previous 24 hours and were, therefore, discharged home whereas all members of the other group were still in hospital and 85% of them were discharged home after hospitalization for 6 to 7 days. Three members (15%) of this group deteriorated and underwent emergency surgery.The results show that addition of PALA to the conventional non-operative treatment of acute cholecystitis enhances recovery and avoids the complications necessitating emergency surgery.


2010 ◽  
Vol 3 (9) ◽  
pp. 10
Author(s):  
DIANA MAHONEY

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