Impact of Enhanced Recovery After Surgery on Postoperative Recovery for Pancreaticoduodenectomy: Pooled Analysis of Observational Study

Introduction: The aim of this study was to evaluate short-term outcomes of patients undergoing mini-invasive rectal resection within an ERAS (enhanced recovery after surgery) protocol. Methods: A prospectively managed database of patients undergoing rectal operations performed at our department between January 2015 and April 2020 was retrospectively analyzed. An ERAS protocol was implemented into clinical practice at our department in April 2016 and mini-invasive rectal procedures in May 2016. The ERAS group consisted of all patients who underwent mini-invasive rectal resections or amputations within the ERAS protocol. The control group consisted of patients who underwent open procedures and received standard perioperative care. The extracted data included basic patient characteristics, surgical data, postoperative recovery parameters, 30-day morbidity, length of postoperative stay and 30-day rehospitalization. Results: A total of 110 patients were included in the study: 67 patients in the ERAS group and 43 in the control group. Within the ERAS group 47 patients underwent robotic procedures and 20 had laparoscopic procedures. Patients in the ERAS group had significantly better clinical and laboratory recovery parameters except for postoperative nausea and vomiting. A significantly lower incidence of paralytic ileus (20.9% vs. 3%) and a shorter length of postoperative stay (13 days vs. 9 days) was found in the ERAS group. The rehospitalization rate and 30-day morbidity were not different between the ERAS and control group. Conclusions: Implementation of the ERAS protocol in combination with mini-invasive approaches leads to better short-term postoperative outcomes after rectal surgery.

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Enhanced recovery after surgery protocol enhances early postoperative recovery after pancreaticoduodenectomy

Hepatobiliary & Pancreatic Diseases International ◽

10.1016/j.hbpd.2018.12.005 ◽

2019 ◽

Vol 18 (2) ◽

pp. 188-193 ◽

Cited By ~ 6

Author(s):

Ramasamy Mahendran ◽

Mallika Tewari ◽

Vinod Kumar Dixit ◽

Hari Shankar Shukla

Keyword(s):

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Postoperative Recovery

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Modified enhanced recovery after surgery protocols are beneficial for postoperative recovery for patients undergoing emergency surgery for obstructive colorectal cancer

Medicine ◽

10.1097/md.0000000000012348 ◽

2018 ◽

Vol 97 (39) ◽

pp. e12348 ◽

Cited By ~ 11

Author(s):

Yuanyuan Shang ◽

Chunbao Guo ◽

Dianliang Zhang

Keyword(s):

Colorectal Cancer ◽

Emergency Surgery ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Postoperative Recovery ◽

Obstructive Colorectal Cancer

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Early postoperative day 0 chest tube removal using a digital drainage device protocol after thoracoscopic major pulmonary resection

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivaa170 ◽

2020 ◽

Vol 31 (5) ◽

pp. 657-663

Author(s):

Karel Pfeuty ◽

Bernard Lenot

Keyword(s):

Chest Tube ◽

Pulmonary Resection ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Lung Resection ◽

Postoperative Recovery ◽

Cardiopulmonary Complication ◽

Drainage Device ◽

Tube Removal ◽

Chest Tube Removal

Abstract OBJECTIVES The aim of this study was to assess the safety of early chest tube removal on postoperative day 0 (POD 0) on the basis of a digital drainage device protocol in patients undergoing thoracoscopic major lung resection and its contribution as a component of an enhanced recovery after surgery programme. METHODS One hundred consecutive patients who underwent thoracoscopic lobectomy or segmentectomy were submitted to the following criteria for chest tube removal: Air flow ≤20 ml/min for at least 4 h without fluid threshold, except if haemorrhagic or chylous. Two groups were defined according to chest tube removal on POD 0 (G0) or POD ≥1 (G1). Primary outcome was pleural complication and secondary outcomes were cardiopulmonary complication, length of drainage, length of stay (LOS), compliance with opioid-free analgesic protocol and readmission. The follow-up was 90 days from discharge. RESULTS The chest tube was removed on POD 0 in 45% of patients (G0). None of them required tube reinsertion for pneumothorax and 1 patient was readmitted for a delayed pleural effusion. Among the 55% remaining patients (G1), the median length of drainage was 2 days, including 3 prolonged air leaks (>5 days). G0 and G1 were not different in terms of cardiopulmonary complication and readmission (6.6% vs 9% and 4.4% vs 7.2%, respectively). The median LOS was 1 day in G0 and 2 days in G1. The compliance with opioid-free analgesic protocol was significantly higher (75% vs 45%, P = 0.004) in G0 compared to G1. CONCLUSIONS Early POD 0 chest tube removal after thoracoscopic major pulmonary resection is safe in selected patients on the basis of a digital drainage device protocol. Also, it may contribute, by reducing early postoperative pain, to enhance postoperative recovery as part of an advanced enhanced recovery after surgery programme.

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Comparative short-term outcomes of enhanced recovery after surgery (ERAS) program and none-ERAS traditional care in elderly patients undergoing lumbar arthrodesis: a retrospective study

10.21203/rs.3.rs-38138/v3 ◽

2021 ◽

Author(s):

Zhong-En Li ◽

Shi-Bao Lu ◽

Chao Kong ◽

Wen-Zhi Sun ◽

Peng Wang ◽

...

Keyword(s):

Postoperative Pain ◽

Elderly Patients ◽

Enhanced Recovery ◽

Enhanced Recovery After Surgery ◽

Postoperative Recovery ◽

Demographic Characteristics ◽

Care Group ◽

Pain Scores ◽

Lumbar Arthrodesis ◽

Traditional Care

Abstract Background: Enhanced recovery after surgery (ERAS) program is an evidence-based improvement over none-ERAS traditional care. The aim of the present study was to analyze the safety, feasibility, and efficacy of an ERAS program in patients over 70 years undergoing lumbar arthrodesis by comparison with none-ERAS traditional care.Methods: During January 2018 to December 2018, patients enrolled received none-ERAS traditional care, while the ERAS program was implemented from January to December 2019. Demographic characteristics, comorbidities, surgical data and postoperative recovery parameters were collected from all patients. Postoperative pain scores were evaluated by visual analog scales (VAS). The clinical outcomes were length of stay (LOS), postoperative complications and postoperative pain scores. Compliance results were also collected.Result: A total of 127 patients were enrolled, including 67 patients in the none-ERAS traditional care group and 60 patients in the ERAS group. The demographic characteristics and comorbidities of the two groups showed no significant differences. The LOS of patients treated with ERAS program (13.6±4.0 days) was significantly less than that of patients treated with none-ERAS traditional care (15.6±3.9 days) (p = 0.034). Complication rate was 8.3% in the ERAS group versus 20.9% in the none-ERAS traditional care group (p = 0.048). VAS (back) in the ERAS group was significantly lower on postoperative day (POD) 1 and POD2. Postoperative recovery parameters were improved in the ERAS group. The overall compliance with the ERAS program was 94%.Conclusions: Based on our results, ERAS program is safer and more effective for elderly patients over 70 undergoing lumbar arthrodesis than none-ERAS traditional care.

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