Results: The analysis included 46 patients in the ERP group and 45 in the standard care group. Median MFD time was reduced in the ERP group (3 days versus 6 days with standard care; P < 0·001), as was LOS (4 days versus 7 days; P < 0·001). The ERP significantly reduced the rate of medical complications (7 versus 27 per cent; P = 0·020), but not surgical complications (15 versus 11 per cent; P = 0·612), readmissions (4 versus 0 per cent; P = 0·153) or mortality (both 2 per cent; P = 0·987). QoL over 28 days was significantly better in the ERP group (P = 0·002). There was no difference in patient satisfaction.
Conclusion:ERPs for open liver resection surgery are safe and effective. Patients treated in the ERP recovered faster, were discharged sooner, and had fewer medical-related complications and improved QoL. Registration number: ISRCTN03274575 (http://www.controlled-trials.com).
through MP. It could indeed explain an important part in the transmission of the infection to patients who claim adopting recommended safety measures.Hence, several measures should be endorsed to tackle the MPrelated SARS-CoV-2 transmission risk. Disinfection with bactericidal wipes adapted to MP could not be completely effective, and specific sanitization protocols should be developed especially for health care workers. 3 Until then, it is crucial during the deconfinment phase to educate the population to limit the use of MP as much as possible, especially in public places and health care institutions. To our opinion, this procedure should be included in the recommended safety measures that are widely broadcasted through the media and science information thread.
This is the first collaborative Enhanced Recovery After Surgery Society guideline for optimal perioperative care for vulvar and vaginal surgeries. An Embase and PubMed database search of publications was performed. Studies on each topic within the Enhanced Recovery After Surgery vulvar and vaginal outline were selected, with emphasis on meta-analyses, randomized controlled trials, and prospective cohort studies. All studies were reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation system. All recommendations on the Enhanced Recovery After Surgery topics are based on the best available evidence. The level of evidence for each item is presented.
Type 3 laryngotracheo-oesophageal clefts are rare congenital anomalies with a high mortality. In the past, transport of such infants to tertiary centres for surgical correction has proved extremely difficult, with the child's ventilatory status often deteriorating to such an extent that ultimate surgical intervention has not proved possible. We describe two cases of successful inter-hospital transfer of infants with type 3 laryngotracheo-oesophageal clefts using the laryngeal mask airway.
The strategy has five elements: (1) strengthening public health data collection and reporting; (2) advancing the practice of pain management; (3) improving access to addiction prevention, treatment, and recovery support services; (4) increasing availability of overdose-reversing drugs; and (5) supporting cutting-edge research in treatment of pain, opioid use disorder, and associated conditions. The Department of Health and Human Services has developed a concerted, coordinated evidence-based effort across department divisions to reduce opioid misuse, prevalence of opioid use disorder, and reduce deaths due to opioid use.
The concept of 'enhanced recovery' following elective surgery is becoming increasingly prominent in the world of perioperative practice. Enhanced recovery pathways (ERP) are being implemented in more and more trusts throughout the UK, and in multiple different surgical specialties. But what does enhanced recovery actually mean and how does it impact upon both patients and healthcare professionals? Our unit has been using an ERP in colorectal surgery since 2007 and we are currently in the process of implementing a pathway for both our orthopaedic and gynaecological patients. This article comprises some background information on the evolution of enhanced recovery, a summary of its key elements and a review of the evidence, including a look at our unit's experience.
Advances in liver resection surgery have lead to reductions in both mortality and morbidity. However morbidity remains high so effective multidisciplinary teamwork is essential to optimise the perioperative care of this patient group. In this article we review the current literature on the perioperative management of patients undergoing liver resection surgery.
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