scholarly journals Enhanced recovery after surgery program reduces length of hospital stay and complications in liver resection

Medicine ◽  
2017 ◽  
Vol 96 (31) ◽  
pp. e7628 ◽  
Author(s):  
Yiyang Zhao ◽  
Han Qin ◽  
Yang Wu ◽  
Bo Xiang
Keyword(s):  
Liver Resection ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Length Of Hospital Stay

scholarly journals Implementation of enhanced recovery after surgery in gynecological operations: a randomized controlled trial

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Amr Nady Abdelrazik ◽  
Ahmad Sameer Sanad
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Gynecologic Surgery ◽  
Complication Rates ◽  
Control Groups ◽  
Analog Scale ◽  
Randomized Controlled

Abstract Background To investigate the effects of enhanced recovery after surgery (ERAS) in patients undergoing gynecologic surgery on length of hospital stay, pain management, and complication rate. Results The length of hospital stay was reduced in ERAS groups when compared with the control groups (3.46 days vs 2.28 days; P < 0.0001; CI − 1.5767 to − 0.7833 for laparotomy groups and 2.18 vs 1.76 days; P = 0.0115; CI − 0.7439 to − 0.0961 for laparoscopy groups respectively). Intraoperative fluid use was reduced in both ERAS groups compared to the two control groups (934 ± 245 ml and 832 ± 197 ml vs 1747 ± 257 ml and 1459 ± 304 respectively; P < 0.0001) and postoperative fluid use was also less in the ERAS groups compared to the control groups (1606 ± 607 ml and 1210 ± 324 ml vs 2682 ± 396 ml and 1469 ± 315 ml respectively; P < 0.0001). Pain score using visual analog scale (VAS) on postoperative day 0 was 4.8 ± 1.4 and 4.1 ± 1.2 (P = 0.0066) for both laparotomy control and ERAS groups respectively, while in the laparoscopy groups, VAS was 3.8 ± 1.1 and 3.2 ± 0.9 (P = 0.0024) in control and ERAS groups respectively. Conclusion Implementation of ERAS protocols in gynecologic surgery was associated with significant reduction in length of hospital stay, associated with decrease intravenous fluids used and comparable pain control without increase in complication rates.

Compliance with enhanced recovery after surgery program in gynecology: are all items of equal importance?

2019 ◽  
Vol 29 (4) ◽  
pp. 810-815 ◽  
Author(s):  
Basile Pache ◽  
Jonas Jurt ◽  
Fabian Grass ◽  
Martin Hübner ◽  
Nicolas Demartines ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Length Of Hospital Stay ◽  
Gynecologic Surgery ◽  
Complication Rates ◽  
Prolonged Length ◽  
Academic Center ◽  
The Impact

IntroductionEnhanced recovery after surgery (ERAS) guidelines in gynecologic surgery are a set of multiple recommendations based on the best available evidence. However, according to previous studies, maintaining high compliance is challenging in daily clinical practice. The aim of this study was to assess the impact of compliance to individual ERAS items on clinical outcomes.MethodsRetrospective cohort study of a prospectively maintained database of 446 consecutive women undergoing gynecologic oncology surgery (both open and minimally invasive) within an ERAS program from 1 October 2013 until 31 January 2017 in a tertiary academic center in Switzerland. Demographics, adherence, and outcomes were retrieved from a prospectively maintained database. Uni- and multivariate logistic regression was performed, with adjustment for confounding factors. Main outcomes were overall compliance, compliance to each individual ERAS item, and impact on post-operative complications according to Clavien classification.ResultsA total of 446 patients were included, 26.2 % (n=117) had at least one complication (Clavien I–V), and 11.4 % (n=51) had a prolonged length of hospital stay. The single independent risk factor for overall complications was intra-operative blood loss > 200 mL (OR 3.32; 95% CI 1.6 to 6.89, p=0.001). Overall compliance >70% with ERAS items (OR 0.15; 95% CI 0.03 to 0.66, p=0.12) showed a protective effect on complications. Increased compliance was also associated with a shorter length of hospital stay (OR 0.2; 95% CI 0.435 to 0.93, p=0.001).ConclusionsCompliance >70% with modifiable ERAS items was significantly associated with reduced overall complications. Best possible compliance with all ERAS items is the goal to achieve lower complication rates after gynecologic oncology surgery.

The contribution of specific enhanced recovery after surgery (ERAS) protocol elements to reduced length of hospital stay after ventral hernia repair

2019 ◽  
Vol 34 (10) ◽  
pp. 4638-4644 ◽  
Author(s):  
Walker Ueland ◽  
Seth Walsh-Blackmore ◽  
Michael Nisiewicz ◽  
Daniel L. Davenport ◽  
Margaret A. Plymale ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hospital Stay ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Length Of Hospital Stay ◽  
Eras Protocol

scholarly journals Enhanced Recovery after Surgery (ERAS) Protocols versus Standard Care in Perioperative Management of Radical Cystectomy with Urinary Diversion

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Shoeib ◽  
M M Yassin ◽  
M K Tolba ◽  
A M M Mohamed
Keyword(s):  
Hospital Stay ◽  
Radical Cystectomy ◽  
Standard Care ◽  
Readmission Rate ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Length Of Hospital Stay ◽  
Full Diet ◽  
Operative Complications ◽  
Stay Time

Abstract Background Bladder cancer is the ninth most common cancer worldwide, with an estimated 430 000 new cases in 2012. Bladder cancer has more than 130,000 deaths per year worldwide, with an estimated male: female ratio of 3.8:1.0. Aim of the Work to examine the current evidence for ERAS in preoperative, intraoperative and post-operative setting of care for RC patients, to propose ERAS evidence-based protocol for patients undergoing Radical Cystectomy in Egypt environment and to compare the effectiveness of ERAS versus standard care on perioperative outcomes after cystectomy including Length of Hospital Stay,bowel movement, Complications and Readmission Rate in 30Day. Patients and Methods This is a prospective randomized comparative study done at the urology departments of Ain Shams University and Nasser institute for research and treatment in 2018. Forty patients were included in this study who were indicated For Radical Cystectomy. They were recruited and randomized in two groups: Group A: where they followed enhanced recovery after Surgery protocols and Group B: where they followed the the classic pre-operative and post-operative protocols. Results We finished to that Enhanced recovery after surgery (ERAS) protocols in radical cystectomy is safe and not associated with any increase in intraoperative and post-operative complications compared to standard protocol. It is associated with reductions in the length of hospital stay, time to return to full diet, time to flatulence, time for defecation and pain post-operative. There is no difference in 30 day readmission rate between ERAS and Standard Care. Our prospective randomized controlled trial covers most of the items recommended for ERAS excluding the use of a laparoscopic or robotic approach, Audit, and use of alvimopan, a peripherally acting μ-opioid antagonist, which is not available in Egypt. Our study reveals many issues that need to be considered when designing a larger more powered study. Conclusion Enhanced recovery after surgery (ERAS) protocols in radical cystectomy is safe and not associated with any increase in intraoperative and post-operative complications compared to standard protocol. It is associated with reductions in the length of hospital stay, time to return to full diet, time to flatulence, time for defecation and pain post operative. There is no difference in 30 day readmission rate between ERAS and Standard Care.

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