scholarly journals Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations—2019 update

2019 ◽  
Vol 29 (4) ◽  
pp. 651-668 ◽  
Author(s):  
Gregg Nelson ◽  
Jamie Bakkum-Gamez ◽  
Eleftheria Kalogera ◽  
Gretchen Glaser ◽  
Alon Altman ◽  
...  
Keyword(s):  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Care Pathway ◽  
Gynecologic Oncology ◽  
Evidence Base ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Meta Analyses ◽  
Eras Protocol

BackgroundThis is the first updated Enhanced Recovery After Surgery (ERAS) Society guideline presenting a consensus for optimal perioperative care in gynecologic/oncology surgery.MethodsA database search of publications using Embase and PubMed was performed. Studies on each item within the ERAS gynecologic/oncology protocol were selected with emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.ResultsAll recommendations on ERAS protocol items are based on best available evidence. The level of evidence for each item is presented accordingly.ConclusionsThe updated evidence base and recommendation for items within the ERAS gynecologic/oncology perioperative care pathway are presented by the ERAS® Society in this consensus review.

scholarly journals Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update

2022 ◽  
Author(s):  
Erik Stenberg ◽  
Luiz Fernando dos Reis Falcão ◽  
Mary O’Kane ◽  
Ronald Liem ◽  
Dimitri J. Pournaras ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Assessment Development ◽  
Meta Analyses ◽  
Large Prospective Cohort

Abstract Background This is the second updated Enhanced Recovery After Surgery (ERAS®) Society guideline, presenting a consensus for optimal perioperative care in bariatric surgery and providing recommendations for each ERAS item within the ERAS® protocol. Methods A principal literature search was performed utilizing the Pubmed, EMBASE, Cochrane databases and ClinicalTrials.gov through December 2020, with particular attention paid to meta-analyses, randomized controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. After critical appraisal of these studies, the group of authors reached consensus regarding recommendations. Results The quality of evidence for many ERAS interventions remains relatively low in a bariatric setting and evidence-based practices may need to be extrapolated from other surgeries. Conclusion A comprehensive, updated evidence-based consensus was reached and is presented in this review by the ERAS® Society.

The financial impact of an enhanced recovery after surgery (ERAS) protocol in an academic gynecologic oncology practice

2020 ◽  
Vol 156 (2) ◽  
pp. 284-287 ◽  
Author(s):  
Zachary L. Gentry ◽  
Teresa K.L. Boitano ◽  
Haller J. Smith ◽  
Dustin K. Eads ◽  
John F. Russell ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Financial Impact ◽  
Oncology Practice ◽  
Eras Protocol

scholarly journals Role and impact of multimodal prehabilitation for gynecologic oncology patients in an Enhanced Recovery After Surgery (ERAS) program

2019 ◽  
Vol 29 (8) ◽  
pp. 1235-1243 ◽  
Author(s):  
Ester Miralpeix ◽  
Gemma Mancebo ◽  
Sonia Gayete ◽  
Marta Corcoy ◽  
Josep-Maria Solé-Sedeño
Keyword(s):  
Functional Capacity ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Psychological Support ◽  
Gynecologic Surgery ◽  
Nutritional Counseling ◽  
Oncology Patients ◽  
Operative Recovery ◽  
Eras Protocol

Patients undergoing major surgery are predisposed to a decrease in functional capacity as a response to surgical stress that can delay post-operative recovery. A prehabilitation program consists of patient preparation strategies before surgery, and include pre-operative measures to improve functional capacity and enhance post-operative recovery. Multimodal prehabilitation may include exercise, nutritional counseling, psychological support, and optimization of underlying medical conditions, as well as cessation of unfavorable health behaviors such as smoking and drinking. Currently, there are no standardized guidelines for prehabilitation, and the existent studies are heterogeneous; however, multimodal approaches are likely to have a greater impact on functional outcomes than single management programs. We have reviewed the literature on prehabilitation in general, and in gynecologic surgery in particular, to identify tools to establish an optimal prehabilitation program within an Enhanced Recovery After Surgery (ERAS) protocol for gynecologic oncology patients. We suggest a safe, reproducible, functional, and easy-to-apply multimodal prehabilitation program for gynecologic oncology practice based on patient-tailored pre-operative medical optimization, physical training, nutritional counseling, and psychological support. The analysis of the prehabilitation program implementation in an ERAS protocol should undergo further research in order to test the efficacy on surgical outcome and recovery after surgery.

A cost analysis of the impact of enhanced recovery after surgery (ERAS) protocol in gynecologic oncology surgery

2019 ◽  
Vol 154 ◽  
pp. 211
Author(s):  
Z.L. Gentry ◽  
T.K.L. Boitano ◽  
H.J. Smith ◽  
J. Russell ◽  
D. Eads ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Eras Protocol ◽  
The Impact

Impact of enhanced recovery after surgery (ERAS) protocol on gastrointestinal function in gynecologic oncology patients undergoing laparotomy

2018 ◽  
Vol 151 (2) ◽  
pp. 282-286 ◽  
Author(s):  
Teresa K.L. Boitano ◽  
Haller J. Smith ◽  
Tullia Rushton ◽  
Mary C. Johnston ◽  
Prentiss Lawson ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Gastrointestinal Function ◽  
Oncology Patients ◽  
Eras Protocol

scholarly journals iColon, a patient-focused mobile application for perioperative care in colorectal surgery: an observational, real-world study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e045526
Author(s):  
Elisa Bertocchi ◽  
Giuliano Barugola ◽  
Irene Gentile ◽  
Teresa Zuppini ◽  
Massimo Zamperini ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Real World ◽  
Perioperative Care ◽  
Mobile Application ◽  
Enhanced Recovery ◽  
Care Pathway ◽  
Digital Health ◽  
Health Sector ◽  
Elective Colorectal Surgery ◽  
Eras Protocol

IntroductionThe enhanced recovery after surgery (ERAS) protocol provides optimised care guidelines for patients undergoing elective colorectal surgery. To ensure high compliance with active ERAS elements, patients must be educated to actively participate in the perioperative care pathway. Mobile health is a rapidly expanding area of the digital health sector that is effective in educating and engaging patients during follow-up. iColon is a mobile application designed by the Operative Unit of General Surgery of IRCCS Sacro Cuore Don Calabria Hospital of Negrar of Valpolicella, which is specifically targeted at patients undergoing elective colorectal surgery. iColon is organised into ERAS phases, and it provides real-time feedback to surgeons about a patient’s adherence to perioperative active ERAS elements.Methods and analysisWe hypothesise that by providing a patient-focused mobile application, compliance with active ERAS elements could be improved.The first coprimary objective is to build patient confidence in using the mobile application, iColon, during perioperative care. The second coprimary objective is to establish patient compliance with active ERAS elements.Secondary objectives include examining: length of stay, 30-day readmission rate, postoperative complications and patient satisfaction of received care.This study is a prospective observational real-world study of patients undergoing elective colorectal surgery who are following the ERAS protocol and using iColon during perioperative periods between September 2020 and December 2022.By educating and engaging patients in the ERAS protocol, the mobile application, iColon, should stimulate patients to be more proactive in managing their healthcare by complying more closely with active ERAS elements.Ethics and disseminationThis study has been approved by the local Ethics Committee with the protocol number 29219 of 25 May 2020. The results will be actively disseminated through peer-reviewed journals, conference presentations and various community engagement activities.

scholarly journals The impact of Enhanced Recovery after Surgery (ERAS) pathways with regard to perioperative outcome in patients with ovarian cancer

2021 ◽  
Author(s):  
Susanne Reuter ◽  
Linn Woelber ◽  
Constantin C. Trepte ◽  
Daniel Perez ◽  
Antonia Zapf ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Postoperative Complications ◽  
Length Of Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Oncology ◽  
Long Term Outcome ◽  
Surgical Data ◽  
Eras Protocol ◽  
The Impact

Abstract Purpose Major surgery for ovarian cancer is associated with significant morbidity. Recently, guidelines for perioperative care in gynecologic oncology with a structured “Enhanced Recovery after Surgery (ERAS)” program were presented. Our aim was to evaluate if implementation of ERAS reduces postoperative complications in patients undergoing extensive cytoreductive surgery for ovarian cancer. Methods 134 patients with ovarian cancer (FIGO I-IV) were included. 47 patients were prospectively studied after implementation of a mandatory ERAS protocol (ERAS group) and compared to 87 patients that were treated before implementation (pre-ERAS group). Primary endpoints of this study were the effects of the ERAS protocol on postoperative complications and length of stay in hospital. Results Preoperative and surgical data were comparable in both groups. Only the POSSUM score was higher in the ERAS group (11.8% vs. 9.3%, p < 0.001), indicating a higher surgical risk in the ERAS group. Total number of postoperative complications (ERAS: 29.8% vs. pre-ERAS: 52.8%, p = 0.011), and length of hospital stay (ERAS: 11 (6–23) vs pre-ERAS: 13 (6–50) days; p < 0.001) differed significantly. A lower fraction of patients of the ERAS group (87.2%) needed postoperative admission to the ICU compared to the pre-ERAS group (97.7%), p = 0.022). Mortality within the ERAS group was 0% vs. 3.4% (p = 0.552) in the pre-ERAS group. Conclusion The implementation of a mandatory ERAS protocol was associated with a lower rate of postoperative complications and a reduced length of stay in hospital. If ERAS has influence on long-term outcome needs to be further evaluated.

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