scholarly journals Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries -- a systematic review

2021 ◽  
Author(s):  
Qianyun Pang ◽  
Liping Duan ◽  
Yan Jiang ◽  
Hongliang Liu
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Long Term Outcomes

scholarly journals Oncologic and long-term outcomes of enhanced recovery after surgery in cancer surgeries — a systematic review

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qianyun Pang ◽  
Liping Duan ◽  
Yan Jiang ◽  
Hongliang Liu
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Current Evidence ◽  
Cochrane Library ◽  
Long Term Outcomes ◽  
High Adherence ◽  
Eras Protocol

Abstract Background Clinical evidence has proved that enhanced recovery after surgery (ERAS) can improve short-term clinical outcomes after various types of surgeries, but the long-term benefits have not yet been examined, especially with respect to cancer surgeries. Therefore, a systematic review of the current evidence was conducted. Methods The Pubmed, Cochrane Library, Embase, and Web of Science databases were searched using the following key words as search terms: “ERAS” or “enhanced recovery” or “fast track”, “oncologic outcome”, “recurrence”, “metastasis”, “long-term outcomes”, “survival”, and “cancer surgery”. The articles were screened using the inclusion and exclusion criteria, and the data from the included studies were extracted and analyzed. Results A total of twenty-six articles were included in this review. Eighteen articles compared ERAS and conventional care, of which, 12 studies reported long-term overall survival (OS), and only 4 found the improvement by ERAS. Four studies reported disease-free survival (DFS), and only 1 found the improvement by ERAS. Five studies reported the outcomes of return to intended oncologic treatment after surgery (RIOT), and 4 found improvements in the ERAS group. Seven studies compared high adherence to ERAS with low adherence, of which, 6 reported the long-term OS, and 3 showed improvements by high adherence. One study reported high adherence could reduce the interval from surgery to RIOT. Four studies reported the effect of altering one single item within the ERAS protocol, but the results of 2 studies were controversial regarding the long-term OS between laparoscopic and open surgery, and 1 study showed improvements in OS with restrictive fluid therapy. Conclusions The use of ERAS in cancer surgeries can improve the on-time initiation and completion of adjuvant chemotherapy after surgery, and the high adherence to ERAS can lead to better outcomes than low adherence. Based on the current evidence, it is difficult to determine whether the ERAS protocol is associated with long-term overall survival or cancer-specific survival.

Enhanced recovery after cardiac surgery and its impact on outcomes: A systematic review

Perfusion ◽  
2021 ◽  
pp. 026765912198895
Author(s):  
Yi Zhang ◽  
Jun Heng Chong ◽  
Amer Harky
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Enhanced Recovery ◽  
Controlled Trial ◽  
Postoperative Outcomes ◽  
Current Evidence ◽  
Long Term Outcomes ◽  
Recent Emergence ◽  
Cardiac Society

Background and Aim: Enhanced Recovery After Surgery (ERAS) protocols are a series of perioperative interventions well-established in improving the care and outcomes of patients. With recent emergence of studies on its implementation in cardiac surgery, this paper represents the first systematic review on current evidence of ERAS efficacy in this field. Methods: Two reviewers independently searched through Pubmed, Cochrane, Google Scholar, Web of Science, Embase and Scopus. Comparative studies with controls that described the implementation of ERAS in all types of cardiac operations from 2001 to 2020 were included. Data extracted included patient demographics, components of ERAS protocol described, types of cardiac surgery, and postoperative outcomes. Results: In the final analysis, nine studies were included, of which there were one randomized controlled trial (RCT), one quasi-experiment and seven retrospective/prospective studies. Significant improvement in hospital and ICU length of stay, as well as reduction in postoperative opioid consumption were demonstrated. No increase in postoperative complications were reported. Conclusion: ERAS in cardiac surgery has shown to be potentially safe and effective in improving certain postoperative outcomes. However, the evidence is limited by the lack of high-quality RCTs. We also found the lack of practice of class 1 recommended interventions set forth by the ERAS Cardiac Society. Furthermore, majority of studies only evaluated the immediate postoperative outcomes of patients, and not the long-term outcomes. RCTs that fully implement measures recommended by the ERAS Cardiac Society, with assessments on both immediate and long-term outcomes, are warranted.

scholarly journals Pre-habilitation in Enhanced Recovery After Surgery Programs: A New Potential for Balneology and Physical Medicine to Benefit Patients

2019 ◽  
Vol 61 (2) ◽  
pp. 78-80
Author(s):  
David Ferson
Keyword(s):  
Quality Of Care ◽  
21St Century ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Surgical Patient ◽  
Physical Medicine ◽  
Long Term Outcomes ◽  
Multidisciplinary Teamwork

Medicine in the 21st century is becoming more integrated and less episodic. The ERAS programs have demonstrated that developing an organized, multidisciplinary teamwork approach to surgical patient care can significantly improve the quality of care and reduce complications. The next step in further improving the ERAS programs and potentially positively influencing the long-term outcomes for the patients is optimal conditioning and preparation before the surgery.

scholarly journals Long-term outcomes of psychological treatment for posttraumatic stress disorder: a systematic review and meta-analysis

2021 ◽  
pp. 1-11
Author(s):  
Maxi Weber ◽  
Sarah Schumacher ◽  
Wiebke Hannig ◽  
Jürgen Barth ◽  
Annett Lotzin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Stress Disorder ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Long Term Outcomes ◽  
Psychological Treatments

Abstract Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, PsycINFO, PSYNDEX, and related articles were searched for randomized controlled trials with at least 12 months of follow-up. Twenty-two studies (N = 2638) met inclusion criteria, and 43 comparisons of cognitive behavioral therapy (CBT) were available at follow-up. Active treatments for PTSD yielded large effect sizes from pretest to follow-up and a small controlled effect size compared with non-directive control groups at follow-up. Trauma-focused treatment (TFT) and non-TFT showed large improvements from pretest to follow-up, and effect sizes did not significantly differ from each other. Active treatments for comorbid depressive symptoms revealed small to medium effect sizes at follow-up, and improved PTSD and depressive symptoms remained stable from treatment end to follow-up. Military personnel, low proportion of female patients, and self-rated PTSD measures were associated with decreased effect sizes for PTSD at follow-up. The findings suggest that CBT for PTSD is efficacious in the long term. Future studies are needed to determine the lasting efficacy of other psychological treatments and to confirm benefits beyond 12-month follow-up.

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