scholarly journals The Optimal Time for Urinary Catheter Removal in Enhanced Recovery After Surgery (ERAS) Protocol After Laparoscopic Rectal Cancer Surgery: When and How?

2021 ◽  
Vol 37 (4) ◽  
pp. 193-194
Author(s):  
Jaeim Lee
Keyword(s):  
Rectal Cancer ◽  
Urinary Catheter ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Cancer Surgery ◽  
Catheter Removal ◽  
Optimal Time ◽  
Rectal Cancer Surgery ◽  
Eras Protocol

scholarly journals Optimal concentration of the transversus abdominis plane block in enhanced recovery after surgery protocols for patients of advanced age undergoing laparoscopic rectal cancer surgery

2018 ◽  
Vol 46 (11) ◽  
pp. 4437-4446 ◽  
Author(s):  
Ping-Chen ◽  
Qing-Song Lin ◽  
Xian-Zhong Lin
Keyword(s):  
Rectal Cancer ◽  
General Anesthesia ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Cancer Surgery ◽  
Optimal Concentration ◽  
Transversus Abdominis ◽  
Rectal Cancer Surgery ◽  
Tap Block ◽  
Transversus Abdominis Plane

Objective The transversus abdominis plane (TAP) block ameliorates visual analogue scale scores and decreases morphine requirements, but its role remains unclear. Patients of advanced age are susceptible to local anesthetic intoxication. We aimed to identify an optimal concentration that can be used in enhanced recovery after surgery (ERAS) without compromising analgesic efficacy. Methods In total, 120 patients aged ≥65 years undergoing laparoscopic rectal cancer surgery received general anesthesia combined with a TAP block using 0.25% ropivacaine (Group A), 0.50% ropivacaine (Group B), or 0.75% ropivacaine (Group C) in a 40-mL volume. Group D only received general anesthesia. Epinephrine, plasma cortisol, interleukin-6, and tumor necrosis factor-α were measured at baseline, skin incision, celiac exploration, and tracheal extubation. The proportions of CD4+ and CD4+/CD8+ cells were measured at baseline and postoperative days 1 and 3. Results The TAP block relieved the stress response and accelerated intestinal functional recovery as shown by significant reductions in VAS scores and anesthetic requirements. However, there was no significant difference between Groups B and C. Conclusion The TAP block plays an important role in ERAS in older patients undergoing laparoscopic rectal cancer surgery, and 0.5% ropivacaine is an optimal concentration that can reduce toxicity without undermining analgesia.

PP294 ADHERENCE WITH THE ERAS-PROTOCOL AND OUTCOMES AFTER COLO-RECTAL CANCER SURGERY

2010 ◽  
Vol 5 (2) ◽  
pp. 138
Author(s):  
U. Gustafsson ◽  
J. Hausel ◽  
A. Thorell ◽  
O. Ljungqvist ◽  
M. Soop ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Eras Protocol

Enhanced recovery after surgery and mini-invasive approaches in rectal cancer surgery – short-term outcomes

2020 ◽  
Vol 99 (12) ◽  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Rectal Surgery ◽  
Postoperative Recovery ◽  
Control Group ◽  
Rectal Cancer Surgery ◽  
Short Term ◽  
Postoperative Stay ◽  
Surgical Data ◽  
Eras Protocol

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.

scholarly journals Key components of enhanced recovery after surgery protocol in lung cancer surgery

2021 ◽  
Vol 8 (3) ◽  
pp. 70-83
Author(s):  
A. K. Каchur ◽  
V. K. Lyadov
Keyword(s):  
Lung Cancer ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Lung Cancer Surgery ◽  
Postoperative Mortality ◽  
Early Mobilization ◽  
Cancer Surgery ◽  
Thoracoscopic Approach ◽  
Thoracic Cancer ◽  
Eras Protocol

Due to the high lung cancer morbidity and the need for surgical intervention in that patient population, introduction of the concept of standard protocol for enhanced recovery after surgery (ERAS) may lead to a significant decrease of the rate of postoperative complications and hospital stay. The aim of the review was to assess the main components of ERAS protocol in thoracic cancer surgery using video-assisted thoracoscopic interventions (VATS). Systematic implementation of specific measures in pre- (patient consulting before the intervention, compliance with fluid and nutrition regimen, exclusion of routine sedation, prophylaxis of venous thrombosis, use of intravenous antibiotics and alcohol skin-prepping solution with chlorohexidine), intra- (prevention of hypothermia, thoracoscopic approach, single-tube approach in anatomic lung resections, exclusion of pleural tube insertion, urethral catheterization for less than 2 hours and only in case of epidural anesthesia) and postoperative (early mobilization and cessation of intravenous infusion, pain control using combination of acetaminophen with NSAIDs, maintenance of normovolemy, use of balanced crystalloid solutions and non-pharmacological measures for nausea and vomiting control) periods promote improved outcomes, decrease of postoperative complication rate and postoperative mortality

scholarly journals Swiss Validation of the Enhanced Recovery After Surgery (ERAS) Database

2021 ◽  
Author(s):  
Basile Pache ◽  
David Martin ◽  
Valérie Addor ◽  
Nicolas Demartines ◽  
Martin Hübner
Keyword(s):  
Missing Data ◽  
Large Scale ◽  
Urinary Catheter ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Length Of Hospital Stay ◽  
Prospective Audit ◽  
Audit System ◽  
Validation Criteria ◽  
Eras Protocol

Abstract Background Enhanced recovery after surgery (ERAS) pathways have considerably improved postoperative outcomes and are in use for various types of surgery. The prospective audit system (EIAS) could be a powerful tool for large-scale outcome research but its database has not been validated yet. Methods Swiss ERAS centers were invited to contribute to the validation of the Swiss chapter for colorectal surgery. A monitoring team performed on-site visits by the use of a standardized checklist. Validation criteria were (I) coverage (No. of operated patients within ERAS protocol; target threshold for validation: ≥ 80%), (II) missing data (8 predefined variables; target ≤ 10%), and (III) accuracy (2 predefined variables, target ≥ 80%). These criteria were assessed by comparing EIAS entries with the medical charts of a random sample of patients per center (range 15–20). Results Out of 18 Swiss ERAS centers, 15 agreed to have onsite monitoring but 13 granted access to the final dataset. ERAS coverage was available in only 7 centers and varied between 76 and 100%. Overall missing data rate was 5.7% and concerned mainly the variables “urinary catheter removal” (16.4%) and “mobilization on day 1” (16%). Accuracy for the length of hospital stay and complications was overall 84.6%. Overall, 5 over 13 centers failed in the validation process for one or several criteria. Conclusion EIAS was validated in most Swiss ERAS centers. Potential patient selection and missing data remain sources of bias in non-validated centers. Therefore, simplified validation of other centers appears to be mandatory before large-scale use of the EIAS dataset.

Safety and feasibility of enhanced recovery after surgery in the patients underwent pancreaticoduodenectomy for hepatobiliary and pancreatic malignancy.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 338-338
Author(s):  
Keisuke Kazama ◽  
Toru Aoyama ◽  
Masaaki Murakawa ◽  
Koichiro Yamaoku ◽  
Yosuke Atsumi ◽  
...  
Keyword(s):  
Perioperative Care ◽  
Urinary Catheter ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gastrointestinal Surgery ◽  
Catheter Removal ◽  
Term Survival ◽  
Oral Fluids ◽  
Pancreatic Malignancy ◽  
Drain Removal

338 Background: Pancreaticoduodenectomy (PD) remains the mainstay of surgical treatment for hepatobiliary and pancreatic malignancy and offers the only chance of long term survival. However, the morbidity and mortality after PD has been reported to be high. Therefore, it is important to determine the most appropriate perioperative care. This study assessed whether enhanced recovery after surgery (ERAS) program is safe and feasible in patients who underwent pancreaticoduodenectomy Methods: The subjects were patients who underwent consecutive PD between 2012 and 2014 at the Department of Gastrointestinal Surgery, Kanagawa Cancer Center. They received perioperative care according to ERAS program. All data were retrieved retrospectively. Outcome measures included postoperative mortality, morbidity, hospitalization and 30-day readmission rate. Key ERAS program targets were: nasogastric tube (NGT) removal [postoperative day (POD) 1]; resumption of oral fluids (POD 2); urinary catheter removal (POD 3); tolerating diet (POD 5); drain removal (POD 7). Results: A total of 109 patients were studied. The overall incidence of morbidity was 51.4%, the incidence of mortality was 1.8%, and the incidence of readmission was 1.8%. The median postoperative hospital stay was 23 days. The proportions of patients achieving key targets were: 93.6% for NGT removal; 94.5% for resumption of oral fluids; 31.2% for urinary catheter removal; 79.8% for tolerating diet; 80.7% for meeting mobility targets, and 37.6% for drain removal. Conclusions: ERAS program is safe and feasible in patients who undergo PD. However, achieving compliance on some targets, especially the removal of catcher and drain, were more challenging.

Sign in / Sign up

Export Citation Format

Share Document