Objective Evidence regarding perioperative care in colorectal surgery has recently increased, leading to changes in classical clinical procedures that make the perioperative period safer and shorter. This survey aimed to evaluate the opinions of Spanish colorectal surgeons on the perioperative management of their patients. Method Emailed surveys submitted to the members of Spanish Coloproctological Associations. Results One hundred and thirty-one (31.7%) of the 413 members participated in the study and responded thus: 21% use clinical pathways and 8% use fast track (FT); 36% use epidural analgesia in colonic surgery and 57% in rectal; 40% use warm air and 23% warm fluids to maintain intraoperative normothermia; 53% prescribe >/= 3000 ml. of iv fluids on the first postoperative day and 6.2%= 2000 ml; 43% never use nasogastric tubes. Oral intake was initiated by 23.5% on the first day, and by 50% when peristalsis began, with an earlier tendency in laparoscopic surgery; 43% believed oral intake reduces ileus, but 12% considered it dangerous. Board accreditation and experience in Coloproctology were significantly associated with a lesser use of nasogastric tubes and earlier feeding. Sixty-nine per cent considered FT reduces postoperative stay and 44% thought that it minimizes complications. Conclusion Spanish surgeons maintain a classical procedural policy, but show tendencies towards optimizing patients' care.
There is general agreement on AP. MBP remained a common practice among Spanish colorectal surgeons except for right colonic resection. Surgeons with more case load and specialization used it significantly less.
cannulated, the right femoral and left axillary veins are cannulated using a percutaneous echo guided approach. Finally the circuit is purged by saline, and connected to the pump. Conclusion: The third step starts with ECC: the pump flow is progressively increased, and simultaneously TVE is started, while in situ perfusion for the liver with refrigerated liver preservation solution is achieved by direct cannulation of the portal trunk. Moreover topical cooling is achieved either with crushed ice in plastic bags or cold water. The fourth step is the liver transection, followed by portal reconstruction. Liver is rewarmed, ECC is weaned and cannulas are removed. Finally, the hepatocojejunostomy is realized.
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