AIM. Evaluation of the results of the implementation of ERP in practice. MATERIALS AND METHODS. Two consecutive series of patients were analyzed. The first cohort was recruited in 2013-2015 (n=124), the second - in 2015-2017 (n=152). Patients were randomized into groups with traditional management and ERP. The postoperative complications, length of stay (LOS) and program adherence were estimated. RESULTS. There was no difference in complication rate in first and second series, and between groups. The postoperative length of stay in the first cohort of patients with ERP was 4.7±0.1, in the second - 5.8±0.2 days (p=0.0003). Age and comorbidity rate did not affect the outcomes of treatment. The factor associated with doctor was significant in terms of discharge. The postoperative LOSin patients with traditional management decreased from 9±0,6 to 7,8±0,3 (p=0,046) with implementation of ERP. CONCLUSION. ERP reduces the postoperative length of stay and does not affect the postoperative complications. This Protocol is doctor-dependent. The implementation of ERP improves the results of treatment for all patients in the clinic.
Colon cancer is one of the most common malignant tumors worldwide. The main treatment for localized colon cancer is surgery. Nowadays laparoscopic colectomies for colon cancer have advantages over open ones, as they provide better short-term results. There has been a continuous improvement in the technique of the operation, and due to the widespread use of laparoscopic stapling and cutting devices, intracorporeal anastomosis is becoming more and more accessible. This article discusses the advantages and disadvantages of various methods for the formation of ileo-transverse anastomosis in laparoscopic right hemicolectomy.
AIM: to evaluate the safety of intra- and extracorporeal ileotransverse anastomosis in laparoscopic right hemicolectomy.PATIENTS AND METHODS: a pilot «case-control» study included two groups of patients, who underwent laparoscopic right colectomy according to a standardized technique. An intracorporeal anastomosis (IA) was formed in the main group (n = 20), in the control group — extracorporeal anastomosis (EA) (n = 18).RESULTS: in main group the postoperative complications rate was 20%, in the control group — 28% (p = 0.71). The postoperative hospital stay in the main group was significantly less than in control (5.0 vs 7.3 days) (p < 0.001).CONCLUSION: the postoperative complications rate in both groups was not significant, but postoperative hospital stay was shorter in IA group. A randomized controlled trial is required.
operative complications and mortality. Person-centred care has been shown to improve concordance between care provider and patient on treatment plans, improve health outcomes and enhance the patient experience. Methods: A patient education programme was developed for patients and carers; delivery of this is tailored to meet individual patient needs. The ERAS education programme also extends to a range of healthcare professionals as they all have apart to play in the patient's journey. The staff education programme targets teams from pre-operative assessment, critical care and the ward and aims to reinforce the principles of ERAS from day 0 to supported early discharge. The ERAS nurse is pivotal in the educational programmes. Additional methods include; cohorting patients together for group support, using visual reminders to promote ERAS principles, DVDs, information booklets, walkway signage, 'what matters to me' boards in patients rooms, sharing targets, goal setting exercises and involving family and carers in care plans and discharge planning. Results: Patient experience data was gathered from patient stories and feedback from discharge questionnaires and the results were displayed in the form of 'You Said e We Did' ward information boards. Data from ERAS performance markers such as length of stay, early mobilisation and time taken to return to normal eating and drinking demonstrate compliance factors that influence patient outcomes and satisfaction. Conclusion: The principles of person-centred care are inherent within the ERAS programme and require added focus and exploitation to manage patient expectations achieve better outcomes and improve patient experience.
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