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Enhanced Recovery After Surgery: Applicability and Results for Abdominal Surgery and Impediments for Universal Usage

Published on Jan 1, 2018
· DOI :10.1007/978-981-13-0161-2_7
Vikram Kate13
Estimated H-index: 13
(JIPMER: Jawaharlal Institute of Postgraduate Medical Education and Research),
Mohsina Subair1
Estimated H-index: 1
(JIPMER: Jawaharlal Institute of Postgraduate Medical Education and Research)
+ 1 AuthorsAnanthakrishnan N20
Estimated H-index: 20
(Mahatma Gandhi Medical College & Research Institute)
Abstract
Surgery is a cause of stress, the intensity of which depends on the procedure. Despite a better understanding of the sequence of events leading to the physiological stress response, there has not been any major change in the perioperative care of patients. Perioperative care is often based on the age old so-called inviolable principles [1]. Elements of perioperative care such as prolonged use of drains, forced bed rest, graduated diets, etc. were deemed essential and were taught to successive generations of surgeons as the standard of care. However, in the light of evolving evidence, many of these traditional principles were not found to be evidence based, and some of them may have been detrimental to the patient’s recovery [2–5]. This has led to the need for a judicious evidence-based approach for accelerating the patients’ recovery. The field of perioperative care has witnessed a revolutionary change in the form of enhanced recovery after surgery (ERAS) pathways or ‘fast-track’ protocols, which primarily aim at sustainable improvements in patient care, both in terms of speed of recovery and more importantly quality.
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References86
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#1Subair Mohsina (JIPMER: Jawaharlal Institute of Postgraduate Medical Education and Research)H-Index: 2
#2Dasarathan Shanmugam (JIPMER: Jawaharlal Institute of Postgraduate Medical Education and Research)H-Index: 2
Last. Vikram Kate (JIPMER: Jawaharlal Institute of Postgraduate Medical Education and Research)H-Index: 13
view all 6 authors...
Objectives The objective of this study was to evaluate the feasibility and efficacy of ERAS pathways in patients undergoing emergency simple closure of perforated duodenal ulcer (PDU).
3 CitationsSource
#1Leah Gramlich (U of A: University of Alberta)H-Index: 28
#2Caroline E. Sheppard (U of A: University of Alberta)H-Index: 8
Last. Gregg Nelson (TBCC: Tom Baker Cancer Centre)H-Index: 16
view all 7 authors...
Enhanced Recovery After Surgery (ERAS) programs have been shown to have a positive impact on outcome. The ERAS care system includes an evidence-based guideline, an implementation program, and an interactive audit system to support practice change. The purpose of this study is to describe the use of the Theoretic Domains Framework (TDF) in changing surgical care and application of the Quality Enhancement Research Initiative (QUERI) model to analyze end-to-end implementation of ERAS in colorectal ...
22 CitationsSource
#1Ryo Tanaka (Osaka Medical College)H-Index: 4
#2Sang-Woong Lee (Osaka Medical College)H-Index: 16
Last. Kazuhisa Uchiyama (Osaka Medical College)H-Index: 27
view all 8 authors...
Background The feasibility of the use of the enhanced recovery after surgery (ERAS) protocol in patients with gastric cancer remains unclear.
15 CitationsSource
#1Nathan J. Curtis (Yeovil District Hospital NHS Foundation Trust)H-Index: 2
#2Emma Noble (Yeovil District Hospital NHS Foundation Trust)H-Index: 2
Last. Nader K. Francis (University of Bath)H-Index: 22
view all 9 authors...
Background Hospital readmission is undesirable for patients and care providers as this can impact short-term recovery and carries financial consequences. It is unknown if readmission has long term implications. Aim To investigate the impact of thirty day readmission on long term overall survival following colorectal cancer resection within enhanced recovery after surgery (ERAS) care and explore the reasons, severity and details of readmission episodes. Methods A dedicated, prospectively populate...
4 CitationsSource
#1Olle Ljungqvist (Örebro University)H-Index: 69
#2Michael J. Scott (National Health Service)H-Index: 15
Last. Kenneth C. H. Fearon (RIE: Edinburgh Royal Infirmary)H-Index: 79
view all 3 authors...
Importance Enhanced Recovery After Surgery (ERAS) is a paradigm shift in perioperative care, resulting in substantial improvements in clinical outcomes and cost savings. Observations Enhanced Recovery After Surgery is a multimodal, multidisciplinary approach to the care of the surgical patient. Enhanced Recovery After Surgery process implementation involves a team consisting of surgeons, anesthetists, an ERAS coordinator (often a nurse or a physician assistant), and staff from units that care fo...
356 CitationsSource
7 CitationsSource
#1Nguyen Xuan ThanhH-Index: 14
#2Anderson ChuckH-Index: 14
Last. Leah GramlichH-Index: 28
view all 8 authors...
Background: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites ( ...
28 CitationsSource
#1Xingwei Xu (NU: Nanjing University)H-Index: 3
#2Yingbin Wang (Shanxi Medical University)H-Index: 1
Last. Jieshou Li (NU: Nanjing University)H-Index: 40
view all 7 authors...
Background We aimed to evaluate postoperative recovery and short-term outcomes of patients undergoing partial hepatectomy managed with a nonstrict and individual enhanced recovery after surgery (ERAS) program.
3 CitationsSource
#1Rui Yang (HUM: Hubei University of Medicine)H-Index: 1
#2Wan Tao (WHU: Wuhan University)H-Index: 1
Last. Xian-xiang Chen (HUM: Hubei University of Medicine)H-Index: 1
view all 7 authors...
Abstract Objective Enhanced recovery after surgery (ERAS) programs are a series of measures being taken during the perioperation to alleviate surgical stress and accelerate the recovery rate of patients. Although several studies reported the efficacy of ERAS in liver surgery, the role of ERAS in laparoscopic hepatectomy is still unclear. This meta-analysis is aimed to evaluate the efficacy and safety of ERAS programs versus traditional care in laparoscopic hepatectomy. Methods We searched PubMed...
14 CitationsSource
#1Jessica C. Wisely (University of Melbourne)H-Index: 1
#2Karen L. Barclay (University of Melbourne)H-Index: 6
Background Enhanced Recovery After Surgery (ERAS) programmes have been used in elective surgery since the 1990s to optimize peri-operative care, reducing post-operative complications, length of stay and overall costs. Following the local introduction of an ERAS programme for colorectal elective patients, it was suggested an increase in the use of ERAS-type principles in emergency patients may have occurred. The aims of this study were to determine whether management changes could be demonstrated...
24 CitationsSource
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