scholarly journals Development and Feasibility of the Early Rehabilitation Program on Postoperative Enhanced Recovery Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

2020 ◽  
Author(s):  
Funa Yang ◽  
Lijuan Li ◽  
Yanzhi Mi ◽  
Limin Zou ◽  
Xiaofei Chu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Physical Function ◽  
Enhanced Recovery ◽  
Rehabilitation Program ◽  
Postoperative Hospital Stay ◽  
Early Rehabilitation ◽  
Control Group ◽  
Function Recovery ◽  
Significant Difference ◽  
Physical Function Recovery

Abstract Background: Perioperative rehabilitation management is essential to enhanced recovery after surgery. Few reports, however, focused on quantitative, detailed early activity plans for patients after esophagectomy. Aim: The purpose of this research was to estimate the effect of the Early Rehabilitation Program (ERP) on the recovery of bowel function and physical function for patients undergoing esophagectomy. Method: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selected from June 2019 to February 2020 and assigned to the intervention group (IG) or the control group(CG) randomly. The participants in IG received an ERP strategy during the perioperative period, and the CG received routine care. The recovery of bowel and physical function, readiness for hospital discharge (RHD) and postoperative hospital stay were evaluated on the day of discharge. Results: 215 cases were enrolled and randomized to the CG (n=108) or IG (n=107). There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the ERP intervention, the IG group presented a significantly shorter time to first flatus (P<0.001) and to first bowel movement postoperative (P=0.024), and a better physical function recovery (P＜0.001), compared with the CG group. The analysis also showed that participants in the IG have higher scores of RHD and shorter length of postoperative stay than the CG (P＜0.05). Conclusion: The findings suggest that the ERP can improve bowel and physical function recovery, ameliorate patients' RHD, and shorten postoperative hospital stay for patients undergoing MIE.Trial registration：ClinicalTrials.gov Identifier: NCT01998230

scholarly journals Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) Based on ERAS in Improving the Physical Function Recovery for Patients Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

2021 ◽  
Author(s):  
Funa Yang ◽  
Lijuan Li ◽  
Yanzhi Mi ◽  
Limin Zou ◽  
Xiaofei Chu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Physical Function ◽  
Minimally Invasive Esophagectomy ◽  
Intervention Group ◽  
Rehabilitation Program ◽  
Invasive Esophagectomy ◽  
Function Recovery ◽  
Significant Difference ◽  
Comprehensive Rehabilitation ◽  
Physical Function Recovery

Abstract BackgroundPerioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Few reports, however, focused on quantitative, detailed early activity plans for patients after minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS inthe recovery of bowel function andphysical functionfor patients undergoingMIE. MethodsIn this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selectedfrom June 2019 to February 2020 and assigned to the intervention group (IG) or the controlgroup(CG)randomly.The participants inIGreceived at-ECRPstrategy during theperioperative period, and the CG received routine care. The recovery of bowel andphysical function, readiness for hospital discharge (RHD) and postoperative hospital stay evaluated on the day of discharge. Results215 cases were enrolled and randomized to theIG (n=107)orCG (n=108). There was no significant difference between the two groups in terms of demographic and clinicalcharacteristics and baseline physical function.After the t-ECRP intervention,the IG group presented a significantly shorter time tofirst flatus(P<0.001) and to first bowel movement postoperative (P=0.024),and a better physical function recovery (P＜0.001), compared with theCG group.The analysis also showed thatparticipants in the IG have higherscores of RHD and shorter length of postoperative stay than the CG (P＜0.05).Conclusions The findings suggest that the t-ECRP can improve bowel andphysical functionrecovery,amelioratepatients'RHD, and shorten postoperative hospital stayfor patients undergoing MIE.Trial registrationClinicalTrials.gov (Identifier: NCT01998230)

scholarly journals Implementation and Effectiveness of Early Chest Tube Removal during an Enhanced Recovery Programme after Oesophago-gastrectomy

2015 ◽  
Vol 53 (197) ◽  
pp. 24-27 ◽  
Author(s):  
Rajeev Bhandari ◽  
You Yong-hao
Keyword(s):  
Pleural Effusion ◽  
Hospital Stay ◽  
Chest Tube ◽  
Enhanced Recovery ◽  
Task Force ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Tube Removal ◽  
Significant Difference ◽  
Chest Tube Removal

Introduction: Oesophageal resection were notoriously complicated and produces a cohort of patients prone to postoperative complications and here we would like to focus on the implementation and effectiveness of early chest tube removal in ERAS after oesophago-gastrectomy considering the various aspect like pleural effusion and reducing the length of hospital stay which ultimately lead to reducing the economic burden on patient.Methods: An ERAS programme was devised and implemented with the support of a dedicated in-hospital task-force. The patients underwent esophago-gastrectomy were randomly divided into two groups: the ERAS group and the control group (non-ERAS). The ERAS group was treated with early removal of the chest tube after surgery, and the control group was treated with traditional way and outcomes were compared between them.Results: The length of hospital stay and the cost of hospitalization in the ERAS group were significantly lower than those in the control group（p<0.05. However, there was no statistical significant difference in the incidences of pleural effusion between the two groups（p＞0.05).Conclusions: The introduction of early chest tube removal as an ERAS programme after oesophago-gastrectomy would not increase the risk of pleural effusion and would not increase the total length of stay and cost of hospitalisation without jeopardising patient safety or clinical outcomes.

scholarly journals Enhanced recovery care versus traditional non- ERAS  care following osteotomies in developmental dysplasia of the hip in children : a retrospective case-cohort study

2020 ◽  
Author(s):  
Jin Li ◽  
Saroj Rai ◽  
Renhao Ze ◽  
Xin Tang ◽  
Ruikang Liu ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Perioperative Complications ◽  
Length Of Hospital Stay ◽  
Developmental Dysplasia ◽  
Control Group ◽  
Postoperative Fever ◽  
Vas Score ◽  
Significant Difference ◽  
Dysplasia Of The Hip

Abstract Background: Enhanced recovery after surgery (ERAS) has been shown to shorten the length of hospital stay and reduce the incidence of perioperative complications in many surgical fields. However, there has been a paucity of research examining the application of ERAS in major pediatric orthopedic surgeries. This study aims to compare the perioperative complications and length of hospital stay after osteotomies in children with developmental dysplasia of the hip (DDH) between ERAS and traditional non-ERAS group. Methods: The ERAS group consisted of 86 patients included in the ERAS program from January 2016 to December 2017. The Control group consisted of 82 DDH patients who received osteotomies from January 2014 to December 2015. Length of hospital stay, physiological function, postoperative visual analogue scale (VAS) score, and postoperative complications were compared between the two groups. Results: The mean duration of hospital stay was significantly reduced from 10.0±3.1 in the traditional care group to 6.0±0.8 days in the ERAS(P<0.001). The VAS score in 3-day was significantly lower in ERAS group (2.9±0.8) than traditional non-ERAS group (4.0±0.8) (P<0.001). However, there was no significant difference in the frequency of breakout pain (VAS >4) between two groups (29.5±6.3 vs.30.6±6.5, P=0.276). The frequency of postoperative fever was lower in the ERAS group. The frequency of urinary tract infection in both groups were not noticeable because the catheter was removed promptly after the surgery. Conclusion: The ERAS protocol is both safe and feasible for pediatric DDH patients undergoing osteotomies, and it can shorten the length of hospital stay without increasing the risk of perioperative complications.

scholarly journals Flexible Ureteroscopic Lithotripsy Based on the Concept of Enhanced Recovery After Surgery

2021 ◽  
Author(s):  
Ling Shu ◽  
Ping Ao ◽  
Zhenxing Zhang ◽  
Dong Zhuo ◽  
Changbin Dong ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Operative Time ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Ureteroscopic Lithotripsy ◽  
Total Cost ◽  
Stone Removal

Abstract Background: To evaluate the efficacy of flexible ureteroscopic lithotripsy (FURSL) based on the concept of enhanced recovery after surgery (ERAS).Methods: 435 patients with upper urinary calculi between 2017-2020 were retrospectively analysed and assigned to ERAS group (ERAS management) and control group (traditional management). Operative time, postoperative ambulation time, postoperative hospital stay, total cost of hospitalization, postoperative complications and stone removal were compared. Results: 427 cases were successfully performed FURSL procedure with 4 cases of ERAS group (n = 216) and 4 cases of control group (n = 219) failed respectively. No postoperative complications occurred in either group except for fever and hematuria. There were no significant difference in postoperative fever and stone removal between the two groups (all p > 0.05). The patients in ERAS group had shorter operative time, shorter postoperative ambulation time, less postoperative severe hematuria, shorter postoperative hospital stay and lower total cost of hospitalization than those in control group (all p < 0.05).Conclusions: FURSL based on the concept of ERAS for the treatment of upper urinary tract calculi is safe and reliable, with rapid postoperative recovery, low cost of hospitalization and worthy of clinical promotion.

scholarly journals The Effect of the Gelatinous Lactulose for Postoperative Bowel Movement in the Patients Undergoing Cesarean Section

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Daisuke Shigemi ◽  
Kazuho Nakanishi ◽  
Miwa Miyazaki ◽  
Yoshie Shibata ◽  
Shunji Suzuki
Keyword(s):  
Cesarean Section ◽  
Hospital Stay ◽  
Bowel Movement ◽  
Bowel Function ◽  
Maternity Hospital ◽  
Postoperative Hospital Stay ◽  
Red Cross ◽  
Control Group ◽  
Gastrointestinal Function ◽  
Significant Difference

Lactulose is a non-digestible disaccharide formed from fructose and galactose. The objective of this study was to assess the effect of lactulose on gastrointestinal function after cesarean section. One hundred patients who underwent cesarean section at the Japanese Red Cross Katsushika Maternity Hospital were enrolled in this study. They were divided into 2 groups by randomization: (1) an L group that was treated with gelatinous lactulose (N = 48) and (2) a control group (C group) that did not receive gelatinous lactulose (N = 52). The interval between cesarean section and first postoperative flatus, defecation, and walking; appearance of symptoms of ileus; use of other medicines for stimulating bowel movement; properties and state of feces; and duration of postoperative hospital stay were compared between the two groups. The two groups did not show a significant difference in postoperative outcomes, except for the incidence of loose or watery stools (50% in the L group and 26.9% in the C group, P=0.03). This study could not demonstrate the apparent effectiveness of lactulose in improving bowel function after cesarean section. Therefore, a routine use of gelatinous lactulose after surgery may negatively impact the patients undergoing cesarean section.

scholarly journals Enhanced recovery after surgery (ERAS) decreases recovery time and improve the recovery effect versus for elective gastric cancer surgery: a single-center randomized controlled trial

2021 ◽  
Author(s):  
Shuhong Lv ◽  
Xin Fan ◽  
Yan Li ◽  
Jinling Yan ◽  
Jing Xu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Controlled Trial ◽  
Cohort Analysis ◽  
Postoperative Recovery ◽  
Postoperative Hospital Stay ◽  
Walking Distance ◽  
Significant Difference

Abstract Background Enhanced recovery after surgery (ERAS) can help patients improve recovery speed, improve patient satisfaction, reduce postoperative pressure and reduce postoperative hospital stay. This study evaluated ERAS feasibility and effectiveness compared with conventional perioperative care and their significance in gastrectomy for patients with gastric cancer. Methods This article is a prospective cohort analysis of 272 patients. This paper investigates tumor morphology, operation information, exhaustion time, ambulation time, walking distance on the operation day and 1 day, 2 days and 3 days after the operation, While blood test indexes related to postoperative recovery and postoperative complications are evaluated. Results The recovery of gastrointestinal function was faster in ERAS patients. There was a significant difference in the time of first exhaust between ERAS group and CC group (54.60 ± 17.41 h vs. 76.71 ± 9.47 h; P < 0.001). There were significant differences in the amount of diet on the day of operation, 1 day, 2 days and 3 days after operation between the two groups (P < 0.001); There was a significant difference in the time of first ambulation between eras group and CC group (1.14 ± 0.76 D vs. 2.74 ± 0.98 D; P < 0.001). There were significant differences in walking distance between the two groups at operation day, 1 day, 2 days and 3 days after operation (P < 0.001). The postoperative hospital stay in the ERAS group was significantly shorter than that in the routine perioperative nursing group (8.38 ± 1.68 D, 11.18 ± 1.38 D; P < 0.001). Conclusion ERAS can reduce the stress after radical resection of gastric cancer, promote intestinal recovery, reduce pain intensity, and improve the recovery ability and satisfaction of patients.

scholarly journals Efficacy Comparison of Five Different Acupuncture Methods on Pain, Stiffness, and Function in Osteoarthritis of the Knee: A Network Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-19 ◽  
Author(s):  
Shaowei Li ◽  
Pingjin Xie ◽  
Zhenghui Liang ◽  
Weihan Huang ◽  
Zhanhui Huang ◽  
...  
Keyword(s):  
Physical Function ◽  
Meta Analysis ◽  
Splitting Method ◽  
Osteoarthritis Of The Knee ◽  
Womac Pain ◽  
Function Recovery ◽  
Significant Difference ◽  
Fire Needle ◽  
And Function ◽  
Physical Function Recovery

The principal objective of this present study was to compare the effects of different acupuncture methods on pain, stiffness, and physical function for osteoarthritis of the knee by the pairwise and network meta-analysis (NMA). A network meta-analysis of randomized controlled trials (RCTs) was searched from three English databases and one Chinese database until January 2018. A pairwise meta-analysis was performed with a random effects model. Then we carried out the NMA within a Bayesian framework. Mean difference (MD) and its 95% confidence interval (CI) were calculated by R 3.4.1, Stata 14.0, and RevMan 5.3 software to assess the relief of pain, the effectiveness for stiffness, and physical function recovery. Node-splitting method was used to calculate the inconsistency. Rank probabilities were assessed and clustered by the surface under the cumulative ranking curve (SUCRA). 16 trials mostly researched short-term effectiveness and showed that fire needle and electro-acupuncture were statistically significant to decrease WOMAC pain and physical function scores when compared with other treatments, but there was no significant difference in stiffness calculations. Our NMA demonstrated that acupuncture with heat pain or electrical stimulation might be suggested as the better choices in all acupuncture methods to osteoarthritis of the knee.

scholarly journals Enhanced recovery after surgery in pediatric gastrointestinal surgery

2019 ◽  
Vol 47 (10) ◽  
pp. 4815-4826 ◽  
Author(s):  
Ruyue Gao ◽  
Heying Yang ◽  
Yanan Li ◽  
Lingbing Meng ◽  
Yaping Li ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hospital Costs ◽  
Gastrointestinal Surgery ◽  
Postoperative Hospital Stay ◽  
Patient Comfort ◽  
Control Group ◽  
Time Duration ◽  
Surgical Data

Objective Enhanced recovery after surgery (ERAS) protocols help optimize inpatient care and minimize discomfort. This study was performed to explore the safety, feasibility, and clinical and social value of ERAS in pediatric gastrointestinal surgery. Methods This study included all children (n = 125) who underwent appendectomy, pyloromyotomy, transabdominal Soave’s procedure, Meckel’s diverticulum resection, or reduction of intussusception in our institution from January to September 2018. We compared surgical outcomes between children who underwent surgery under conventional perioperative regimens (control group, n = 57) and those who were treated with ERAS protocols (ERAS group, n = 68). Results There were no significant intergroup differences in demographic or surgical data. However, the bowel function recovery time, postoperative intravenous nutrition time, duration of postoperative hospital stay, and hospital costs were significantly lower in the ERAS group than control group. There was no significant intergroup difference in the complication rate. Conclusions Our results indicate that implementation of ERAS protocols is safe and feasible in pediatric gastrointestinal surgery. They can improve patient comfort, shorten the duration of the postoperative hospital stay, reduce hospital costs, and accelerate postoperative rehabilitation without increasing the risk of postoperative complications. Therefore, ERAS protocols deserve wider implementation and promotion.

scholarly journals P382 Application of enhanced recovery after surgery in single-port laparoscopic partial small intestine resection in the treatment of Crohn’s disease

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S357-S357
Author(s):  
Y LI ◽  
Z Zhou ◽  
D Yao ◽  
L Zheng ◽  
Y Duan ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Laparoscopic Surgery ◽  
Crohn's Disease ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Single Incision Laparoscopic Surgery

Abstract Background Single-incision laparoscopic surgery (SILS) with enhanced recovery after surgery (ERAS) can reduce operation trauma and accelerate postoperative rehabilitation. This study aims to investigate the safety and feasibility of SILS with ERAS in the treatment of Crohn’s disease. Methods Thirty patients with Crohn’s disease were randomly assigned to receive traditional laparoscopic surgery plus ERAS (n = 20) and SILS plus ERAS (n = 18)，respectively. Comparisons and analysis were made between the two groups in the perioperative conditions. Results There were significant differences in the mean operation time between the two groups (p &lt; 0.01)，There were no significant differences in the intra-operative blood loss, postoperative complications rates, the time to first flatus and treatment cost (p &gt; 0.05). There were significant differences in the postoperative hospital stay between the two groups (p &lt; 0.05). WBC, CRP and PCT in SILS plus ERAS group were lower than those in the control group at the first days and the third days after operation, the differences were statistically significant (p &lt; 0.05). Conclusion SILS plus ERAS can shorten postoperative hospital stay and facilitate bowel function recovery in the treatment of Crohn’s disease. It is worthwhile to mention the nice cosmetic benefits of SILS, the perioperative SILS plus ERAS program is safe and effective and should be popularised in Crohn’s disease.

scholarly journals Application of accelerated rehabilitation surgery concept in laparoscopic radical gastrectomy cancer for patients aged ≥70 years

2020 ◽  
Author(s):  
Jun Ma ◽  
Hongliang Shao ◽  
Yanzhong Wang ◽  
Yirui Chen ◽  
Yiping Mou
Keyword(s):  
Hospital Stay ◽  
Clinical Data ◽  
Pulmonary Infection ◽  
Postoperative Hospital Stay ◽  
Control Group ◽  
Radical Gastrectomy ◽  
Postoperative Rehabilitation ◽  
Accelerated Rehabilitation ◽  
Significant Difference ◽  
First Time

Abstract Objective: To explore the application effect of accelerated rehabilitation surgery on laparoscopic radical gastrectomy cancer for patients aged ≥70 years.Methods: Retrospective analysis of 120 aged ≥70 patients’ clinical data undergoing laparoscopic radical gastrectomy in our hospital from January 2017 to December 2018, which were divided into accelerated rehabilitation group (n = 73) and control group (n = 47). By comparing the postoperative clinical data of the two groups, we explored the application effect of accelerated rehabilitation surgery on laparoscopic radical gastrectomy cancer for patients aged ≥70 years.Results: Compared with the control group, the first time to get out of bed (2.1 ± 0.9 days vs 3.8 ± 1.5 days, P<0.01), the first exhaust time (3.2 ± 0.8 days vs 3.9 ± 1.2 days, P<0.01) and the first time to eat liquid food after surgery (1.8 ± 0.9 days vs 3.2 ± 1.3 days, P<0.01), and postoperative hospital stay (12.7 ± 4.3 days vs 15.8 ± 6.4 days, P<0.01) in the rehabilitation group were significantly lower. There was no significant difference in the overall postoperative complications between the two groups (P<0.05), however, the complications of pulmonary infection in the accelerated rehabilitation group was significantly lower than that in the control group (1.4% vs 10.6%, P = 0.03). Conclusions: The application of accelerated rehabilitation surgery concepts and measures after surgery in laparoscopic radical gastrectomy cancer for patients aged ≥70 years can promote early postoperative rehabilitation, reduce postoperative hospital stay, and reduce the incidence of postoperative pulmonary infection complications.

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