Current state of benefits of Enhanced Recovery After Surgery (ERAS) in spinal surgeries: a systematic review of the literature

2021 ◽  
Author(s):  
Ismail Zaed ◽  
Bianca Bossi ◽  
Mario Ganau ◽  
Benedetta Tinterri ◽  
Mario Giordano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Review Of The Literature ◽  
Current State

scholarly journals Enhanced recovery after surgery in pediatric spine surgery: systematic review

2021 ◽  
Vol 18 (4) ◽  
pp. 6-27
Author(s):  
Aleksandr Petrovich Saifullin ◽  
Andrei Evgenievich Bokov ◽  
Alexander Yakovlevich Aleynik ◽  
Yulia Alexandrovna Israelyan ◽  
Sergey Gennadevich Mlyavykh
Keyword(s):  
Systematic Review ◽  
Children And Adolescents ◽  
Spinal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Operation Time ◽  
Early Mobilization ◽  
Cochrane Library ◽  
Control Group ◽  
Review Of The Literature

Objective. To conduct a systematic review of the literature on the use of enhanced recovery after surgery (ERAS) protocols in spinalsurgery of children and adolescents to determine the existing evidence of the effectiveness of ERAS implementation in clinical practice.Material and Methods. The authors conducted a systematic review of the literature on ERAS in spinal and spinal cord surgery in children and adolescents selected in the databases of medical literature and search resources of PUBMED/MEDLINE, Google Scholar, Cochrane Library and eLibrary according to the PRISMA guidelines and the PICOS inclusion and exclusion criteria.Results. A total of 12 publications containing information on the treatment of 2,145 children, whose average age was 14.0 years (from 7.2 to 16.1), were analyzed. In the reviewed publications, the average number of key elements of the ERAS program was 9 (from 2 to 20), and a total of 23 elements used in spinal surgery in children and adolescents were identified. The most commonly used elements were preoperative education and counseling, prevention of infectious complications and intestinal obstruction, multimodal analgesia, refusal of routine use of drains, nasogastric probes and urinary catheters, standardized anesthesia protocol, early mobilization and enteral loading. The introduction of the ERAS protocol into clinical practice allowed to reduce the complication rate in comparison with the control group by 8.2 %(from 2 to 19 %), the volume of blood loss by 230 ml (from 75 to 427 ml), the operation time by 83 minutes (from 23 to 144 minutes), theduration of hospitalization by 1.5 days (from 0.5 to 3 days) and the total cost of treatment by 2258.5 dollars (from 860 to 5280 dollars).The ERAS program was implemented in pediatric clinics in the USA (75 %), France (8 %) and Canada (17 %).Conclusion. The conducted systematic review of the literature allows us to conclude that the technology of enhanced recovery after surgery is a promising technology that improves surgical outcomes and is applicable in pediatric practice. There is a significant shortage of published studies evaluating the implementation of ERAS in pediatric surgical practice in general, and in spinal surgery in particular, which requires further prospective randomized studies to evaluate ERAS in spinal surgery in children and adolescents.

Clinical utility of enhanced recovery after surgery pathways in pediatric spinal deformity surgery: systematic review of the literature

2020 ◽  
pp. 1-14
Author(s):  
Zach Pennington ◽  
Ethan Cottrill ◽  
Daniel Lubelski ◽  
Jeff Ehresman ◽  
Kurt Lehner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spinal Deformity ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Reoperation Rate ◽  
Review Of The Literature ◽  
Patient Controlled Analgesia ◽  
Pain Scores ◽  
Spinal Deformity Surgery ◽  
Quantitative Analyses

OBJECTIVESMore than 7500 children undergo surgery for scoliosis each year, at an estimated annual cost to the health system of $1.1 billion. There is significant interest among patients, parents, providers, and payors in identifying methods for delivering quality outcomes at lower costs. Enhanced recovery after surgery (ERAS) protocols have been suggested as one possible solution. Here the authors conducted a systematic review of the literature describing the clinical and economic benefits of ERAS protocols in pediatric spinal deformity surgery.METHODSThe authors identified all English-language articles on ERAS protocol use in pediatric spinal deformity surgery by using the following databases: PubMed/MEDLINE, Web of Science, Cochrane Reviews, EMBASE, CINAHL, and OVID MEDLINE. Quantitative analyses of comparative articles using random effects were performed for the following clinical outcomes: 1) length of stay (LOS); 2) complication rate; 3) wound infection rate; 4) 30-day readmission rate; 5) reoperation rate; and 6) postoperative pain scores.RESULTSOf 950 articles reviewed, 7 were included in the qualitative analysis and 6 were included in the quantitative analysis. The most frequently cited benefits of ERAS protocols were shorter LOS, earlier urinary catheter removal, and earlier discontinuation of patient-controlled analgesia pumps. Quantitative analyses showed ERAS protocols to be associated with shorter LOS (mean difference −1.12 days; 95% CI −1.51, −0.74; p < 0.001), fewer postoperative complications (OR 0.37; 95% CI 0.20, 0.68; p = 0.001), and lower pain scores on postoperative day (POD) 0 (mean −0.92; 95% CI −1.29, −0.56; p < 0.001) and POD 2 (−0.61; 95% CI −0.75, −0.47; p < 0.001). There were no differences in reoperation rate or POD 1 pain scores. ERAS-treated patients had a trend toward higher 30-day readmission rates and earlier discontinuation of patient-controlled analgesia (both p = 0.06). Insufficient data existed to reach a conclusion about cost differences.CONCLUSIONSThe results of this systematic review suggest that ERAS protocols may shorten hospitalizations, reduce postoperative complication rates, and reduce postoperative pain scores in children undergoing scoliosis surgery. Publication biases exist, and therefore larger, prospective, multicenter data are needed to validate these results.

Implementation of ERAS (Enhanced Recovery After Surgery) protocols for radical cystectomy patients: The pathway to standardization. A systematic review

2021 ◽  
Author(s):  
R. España-Navarro ◽  
P Rabadán-Márquez ◽  
D. Pérez-Argüelles ◽  
N Sánchez-Martínez ◽  
D Hernández-Alcaraz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radical Cystectomy ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery

scholarly journals A systematic review of enhanced recovery after surgery for vascular operations

2019 ◽  
Vol 70 (2) ◽  
pp. 629-640.e1 ◽  
Author(s):  
Katharine L. McGinigle ◽  
Jens Eldrup-Jorgensen ◽  
Rebecca McCall ◽  
Nikki L. Freeman ◽  
Luigi Pascarella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery

scholarly journals Are enhanced recovery programs in colorectal surgery feasible and useful in the elderly? A systematic review of the literature

2017 ◽  
Vol 154 (1) ◽  
pp. 29-35 ◽  
Author(s):  
M.-V. Launay-Savary ◽  
M. Mathonnet ◽  
A. Theissen ◽  
S. Ostermann ◽  
A. Raynaud-Simon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
The Elderly ◽  
Review Of The Literature ◽  
Recovery Programs ◽  
Enhanced Recovery Programs

Outcomes of Enhanced Recovery After Surgery (ERAS) in Gynecologic Oncology—A Systematic Review and Meta-analysis

2021 ◽  
Vol 76 (4) ◽  
pp. 202-203
Author(s):  
S. P. Bisch ◽  
C. A. Jago ◽  
E. Kalogera ◽  
H. Ganshorn ◽  
L. A. Meyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Gynecologic Oncology

scholarly journals Enhanced recovery after surgery in paediatrics: a review of the literature

BJA Education ◽  
2020 ◽  
Vol 20 (7) ◽  
pp. 235-241
Author(s):  
K. Roberts ◽  
M. Brindle ◽  
D. McLuckie
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Review Of The Literature
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