scholarly journals Protocolo ERAS® en cirugía colorrectal

2021 ◽  
Vol 113 (2) ◽  
pp. 176-188
Author(s):  
William Maclean ◽  
◽  
Paul Mackenzie ◽  
Chris Limb ◽  
Timothy Rockall
Keyword(s):  
Colorectal Surgery ◽  
Stress Reduction ◽  
Multidisciplinary Approach ◽  
Physiological Stress ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Care ◽  
Evidence Based ◽  
High Quality ◽  
High Quality Research

Enhanced Recovery After Surgery (ERAS®) in colorectal surgery is a protocol that promotes quicker return to function. It follows the latest evidence-based research to promote stress reduction related to surgery. The recommended perioperative pathway is fine-tuned, dynamic and in line with the latest evidence-based research to enhance all aspects of the patient’s surgical care. We describe the four aspects for a patient undergoing colorectal surgery – pre-admission, pre-operative, intra-operative and post-operative. The running theme is to reduce overall physiological stress related to surgery and interventions overlap throughout the patient’s pathway. Using a multidisciplinary approach, adherence to ERAS® in colorectal surgery with ≥70 % compliance to the ERAS interventions has shown a risk reduction of 5-year cancer-related death by 42%. The optimum interventions are not only determined through the publication of high-quality research, but regular international collaboration enables experience and research to be shared and care standardised

scholarly journals Implementation of enhanced recovery after surgery- ERAS, a paradigm shift in surgery

2018 ◽  
Vol 5 (1) ◽  
pp. 1-2
Author(s):  
Jay Narayan Shah
Keyword(s):  
Colorectal Surgery ◽  
Social Services ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Collaborative Group ◽  
Surgical Trauma ◽  
Evidence Based ◽  
Consensus Protocol ◽  
Research Education ◽  
Operative Care

The history of enhanced recovery after surgery (ERAS) has its roots to the earlier ERAS Study Group. This was a collaborative group on peri-operative care to further develop ideas put forth in the 1990’s by Professor Henrik Kehlet of University of Copenhagen. Kehlet reported that the morbidity, mortality and overall costs of surgery requires multimodal interventions to reduce pain; cardiopulmonary, infective and thromboembolic complications; cerebral dysfunction; nausea and gastrointestinal paralysis, fatigue and prolonged recovery. The ERAS Society, registered and based in Stockholm, has over the years developed ‘perioperative care’ strategies to improve recovery after surgery through research, education, audit and implementation of evidence-based practice. An evidence-based consensus protocol for patients undergoing colon surgery was developed and published by the ERAS Study Group3 and later the group showed that just a protocol was not sufficient to change surgical practice in accordance with ERAS. The ‘manual of fast track recovery for colorectal surgery (Springer)’ was published by the ERAS Society as 1st in the series of enhanced recovery. Thereafter various professional societies and organizations around the world have worked together to develop, modify, promote and propagate ERAS. From its original work on colorectal surgery, the ERAS is now implemented in virtually all the disciplines of surgeries and the guidelines are available at ERAS Society website. The strategies of ERAS is designed for ‘preoperative, intraoperative and postoperative care’ through multimodal, integrated, multidisciplinary approach from all the stake holders: the patient, surgeons, anaesthesiologists, pain specialists, nursing staff, physical and occupational therapists, social services, and hospital administration. It advocates of the standardized medical care to improve the outcomes and lower the health care costs by minimizing surgical trauma, postoperative pain, complications, length of hospital stay, while expediting recovery and improving the overall outcomes.

Postoperative Outcomes within Enhanced Recovery after Surgery Protocol in Colorectal Surgery. (Power Study)

2018 ◽  
Author(s):  
Javier Ripollés-Melchor ◽  
José M. Ramírez-Rodríguez ◽  
Rubén Casans-Francés ◽  
César Aldecoa ◽  
Ane Abad-Motos ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Outcomes ◽  
Power Study

scholarly journals Operative Time and Outcome of Enhanced Recovery After Surgery After Laparoscopic Colorectal Surgery

2014 ◽  
Vol 18 (2) ◽  
pp. 265-272 ◽  
Author(s):  
Oliver J. Harrison ◽  
Neil J. Smart ◽  
Paul White ◽  
Adela Brigic ◽  
Elinor R. Carlisle ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Operative Time ◽  
Enhanced Recovery ◽  
Laparoscopic Colorectal Surgery ◽  
Enhanced Recovery After Surgery

Goal-directed Fluid Therapy Does Not Reduce Primary Postoperative Ileus after Elective Laparoscopic Colorectal Surgery

2017 ◽  
Vol 127 (1) ◽  
pp. 36-49 ◽  
Author(s):  
Juan C. Gómez-Izquierdo ◽  
Alessandro Trainito ◽  
David Mirzakandov ◽  
Barry L. Stein ◽  
Sender Liberman ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Fluid Therapy ◽  
Postoperative Ileus ◽  
Enhanced Recovery ◽  
Laparoscopic Colorectal Surgery ◽  
Enhanced Recovery After Surgery ◽  
Therapy Group ◽  
Control Group ◽  
Goal Directed Fluid Therapy ◽  
The Impact

Abstract Background Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. Methods Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. Patients were assigned randomly to receive intraoperative goal-directed fluid therapy (goal-directed fluid therapy group) or fluid therapy based on traditional principles (control group). Primary postoperative ileus was the primary outcome. Results One hundred twenty-eight patients were included and analyzed (goal-directed fluid therapy group: n = 64; control group: n = 64). The incidence of primary postoperative ileus was 22% in the goal-directed fluid therapy and 22% in the control group (relative risk, 1; 95% CI, 0.5 to 1.9; P = 1.00). Intraoperatively, patients in the goal-directed fluid therapy group received less intravenous fluids (mainly less crystalloids) but a greater volume of colloids. The increase of stroke volume and cardiac output was more pronounced and sustained in the goal-directed fluid therapy group. Length of hospital stay, 30-day postoperative morbidity, and mortality were not different. Conclusions Intraoperative goal-directed fluid therapy compared with fluid therapy based on traditional principles does not reduce primary postoperative ileus in patients undergoing laparoscopic colorectal surgery in the context of an Enhanced Recovery After Surgery program. Its previously demonstrated benefits might have been offset by advancements in perioperative care.

scholarly journals Early Recovery after Caeserean Section What is Possible in Our Setup to Travel the Less Trodden Path: A Review

2021 ◽  
pp. 188-194
Author(s):  
Pratibha Deshmukh ◽  
Priyanka Deshmukh ◽  
Parag Sable ◽  
Vivek Chakole
Keyword(s):  
Caesarean Section ◽  
Colorectal Surgery ◽  
Surgical Procedures ◽  
Consensus Statement ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Developed Countries ◽  
Early Recovery ◽  
Obstetric Anaesthesia

Enhanced recovery after surgery is a concept put forward by Henrik Kehlet in 1997 for colorectal surgery & presented a protocol. Since then, it is adopted for various surgical procedures in many developed countries. Obstetricians & obstetric anaesthesiologists are also following the same line. In 2020 Society for obstetric anaesthesia & perinatology (SOAP) USA published a consensus statement on “early recovery after caesarean section”, presenting the pathways. Is it possible to adopt it fully in our country? Do we need to modify here & there? We are trying to find out the answers.

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