Enhanced Recovery After Surgery (ERAS) Eliminates Racial Disparities in Postoperative Length of Stay After Colorectal Surgery

Wahl, Tyler S.; Goss, Lauren; Morris, Melanie S.; Gullick, Allison A.; Richman, Joshua S.; Kennedy, Gregory D.; Cannon, Jamie A.; Vickers, Selwyn M.; Knight, Sara J.; Simmons, Jeffrey W.; Chu, Daniel I.

doi:10.1097/sla.0000000000002307

Cited by 126 publications

(86 citation statements)

References 34 publications

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“…Standardization is in itself a virtue during a crisis: the CDC states that, "making decisions about ventilator distribution and triage using a standard framework for incident management creates a clear hierarchy of accountability and responsibility, facilitates consistent communication and helps minimize differential treatment of patients" [11]. Across medicine the use of standardized protocols has been shown to decrease medical provider implicit bias and has been shown to decrease healthcare disparities [39,40]. Crucially, a standardized document would also ensure that each hospital has a robust triage decisions appeals process in place, since the total immunity granted to healthcare workers and institutions by the EDTPA renders legal avenues of appeal moot.…”

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confidence: 99%

No protocol and no liability: a call for COVID crisis guidelines that protect vulnerable populations

2020

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The COVID-19 pandemic is revealing the unacceptable health disparities across New York City and in this country. The mortality rates of vulnerable and minority populations alone suggest a need to re-evaluate clinical decision making protocols, especially given the recently passed Emergency or Disaster Treatment Protection Act, which grants healthcare institutions full immunity from liability stemming from resource allocation/triage decisions. Here we examine the disparity literature against resource allocation guidelines, contending that these guidelines may propagate allocation of resources along ableist, ageist and racial biases. Finally, we make the claim that the state must successfully develop ones that ensure the just treatment of our most vulnerable.

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confidence: 99%

No protocol and no liability: a call for COVID crisis guidelines that protect vulnerable populations

2020

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“…Abdominal muscles fulfill an important function in the organism: they are stabilizers. Spine motility range limitation can be the cause of spine pain for patients who have surgery [22,23]. The other problem of patients who underwent colorectal cancer surgery is the postoperative scar.…”

Section: Discussionmentioning

confidence: 99%

Prospective evaluation of muscle strength and spine joint motility of patients who underwent surgery for colorectal cancer by open and laparoscopic methods.

Głowacka-Mrotek

Tarkowska

Jankowski

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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Introduction: The current trend in oncological surgery is to minimize its degree of invasiveness while maintaining a satisfactory survival rate. Surgical treatments within the large intestine are applied through traditional open surgery (OS) or laparoscopic surgery (LS). Aim: The purpose of this nonrandomized, prospective, single-centered clinical examination was to compare motility within the spine joints and evaluate abdominal muscle strength of patients who underwent LS or OS for colorectal cancer. Material and methods: Seventy-two patients were included in the study. Open surgery was applied to 35 patients and LS was applied to 37 patients. Motility range of the thoracic and lumbar spine, muscle strength of abdominal muscles, and pain evaluation by the Visual Analogue Scale (VAS) of the studied group were evaluated twice (on the day of admission to the ward and on the fifth day after the surgery). Results: Both types of surgical intervention resulted in a decrease of the rectus abdominis and abdominal oblique muscle strength as well as a decrease of the range of thoracic and lumbar spine joint motility (p < 0.001). In the first research period, no statistically significant differences of tested parameters between the groups were found. In the second period, patients who underwent LS achieved better results within the extension of lumbar spine section (p = 0.0339), rectus abdominis strength (p = 0.0105), and left abdominal oblique muscles (p = 0.004). Conclusions: Both types of surgical intervention (LS and OS) result in reduction of spine joint motility range and abdominal muscle strength. Laparoscopic surgery disrupts the spine joint motility and abdominal muscle strength to a lesser extent than OS.

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“…The clinical focus is on optimizing patient care processes such as shortening the time of examination and tubeless. The reducing postoperative complications and shortening LOS as a criterion for evaluating the feasibility of the ERAS program by most of clinical surgeons [21].…”

Section: Main Textmentioning

confidence: 99%

No drains in thoracic surgery with ERAS program

Shen

Che

2020

J Cardiothorac Surg

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Enhanced recovery after lobectomy surgery (ERAS) concept has been greatly developed between clinical implementation and minimally invasive surgery. In addition to the minimally invasive surgery, the management of the perioperative catheter has also attracted everyone's attention. Tubeless minimally invasive treatment includes no urinary catheter placement during the operation and no chest tube after the operation. Here, we summarized all the reports on no urinary catheterization and no chest tube in patients with thoracic surgery and the impact of postoperative length of stay (LOS) and postoperative complications. We find that avoiding chest drain and urinary catheter placement after the surgery appears to be safe and beneficial for patients.

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Enhanced Recovery After Surgery (ERAS) Eliminates Racial Disparities in Postoperative Length of Stay After Colorectal Surgery

Cited by 126 publications

References 34 publications

No protocol and no liability: a call for COVID crisis guidelines that protect vulnerable populations

No protocol and no liability: a call for COVID crisis guidelines that protect vulnerable populations

Prospective evaluation of muscle strength and spine joint motility of patients who underwent surgery for colorectal cancer by open and laparoscopic methods.

No drains in thoracic surgery with ERAS program

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