Aceleração da recuperação após protocolo cirúrgico versus cuidados perioperatórios convencionais em cirurgia colorretal. Um estudo de coorte em centro único

Ripollés‐Melchor, Javier; Varela, María Luisa de Fuenmayor; Camargo, Susana Criado; Fernández, Pablo Jerez; Barrio, Álvaro Contreras del; Martínez‐Hurtado, Eugenio; Francés, R. Casans; Abad‐Gurumeta, Alfredo; Ramírez-Rodríguez, José Manuel; Vecino, J.M. Calvo

doi:10.1016/j.bjan.2018.01.003

Cited by 9 publications

(3 citation statements)

References 36 publications

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“…The length of hospital stay also depends on whether the patient underwent emergency or elective surgery. Our series demonstrated the median hospital stay of 5.7 days (1–20 days) for elective surgeries and 8.5 days (2–30 days) for emergency surgeries which is comparable to published literature [ 14 ]. Strict enforcement of ERAS protocols especially during the postoperative period helped us achieve equivalent results.…”

Section: Discussionsupporting

confidence: 86%

Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour

Sukumar

Pandey

Kumar

et al. 2020

Indian J Surg Oncol

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The health services across the world have been deeply impacted by the ongoing COVID-19 pandemic which has resulted in diversion of resources to testing, isolating and treating COVID-19 patients. This meant cutting down resources and manpower away of various healthcare facilities and severely hampering the functioning of various cancer services across the world. It is however, important to understand, cancer itself is a life-threatening condition, and there is a need to continue running cancer care services, at least for those who needed the most. Various clinical societies have put forward guidelines and protocols to help continue surgical services during the pandemic. The role of minimally invasive surgery (MIS) was initially questioned at the start of the pandemic, however gradually increasing evidence favored MIS as it reduced hospital stay and complication. Enhanced recovery programs which have been introduced to various fields of surgery to improve outcomes and reduce hospital stay. It plays an essential role in times like this, where the optimal usage of minimal resources is essential. We embraced these methods to ensure safety of our patients and staff and at the same time provide the highest standards of care. Here we are presenting our experience of running a colorectal surgical unit during these difficult times with emphasis on promotion of minimally invasive surgery, at the epicenter of the pandemic in India.

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Section: Discussionsupporting

confidence: 86%

Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour

Sukumar

Pandey

Kumar

et al. 2020

Indian J Surg Oncol

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“…In a recent meta-analysis, the application of fast-track protocols decreased the rates of post-surgical complications 8 . This fact was confirmed in a prospective study by Wood et al 28 that followed patients in the first 30 postoperative days and in a Spanish series 20 that followed patients who underwent laparoscopic operations and evaluated complications up to the period of 180 days. The most commonly observed gain was in reducing the length of hospital stay as observed in the retrospective Cohort by Wisely et al 27 , in the systematic review by Paduraru et al 18 and in a recent study comparing patients undergoing gastric bypass 1 .…”

Section: Discussionmentioning

confidence: 72%

Acerto Project: Impact on Assistance of a Public Emergency Hospital

Sampaio

Leal

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: In Brazil, the goal-based approach was named Project ACERTO and has obtained good results when applied in elective surgeries with shorter hospitalization time, earlier return to activities without increased morbidity and mortality. Aim: To analyze the impact of ACERTO on emergency surgery care. Methods: An intervention study was performed at a trauma hospital. Were compared 452 patients undergoing emergency surgery and followed up by the general surgery service from October to December 2018 (pre-ACERTO, n=243) and from March to June 2019 (post-ACERTO, n=209). Dietary reintroduction, volume of infused postoperative venous hydration, duration of use of catheters, probes and drains, postoperative analgesia, prevention of postoperative vomiting, early mobilization and physiotherapy were evaluated. Results: After the ACERTO implantation there was earlier reintroduction of the diet, the earlier optimal caloric intake, earlier venous hydration withdrawal, higher postoperative analgesia prescription, postoperative vomiting prophylaxis and higher physiotherapy and mobilization prescription were achieved early in all (p<0.01); in the multivariate analysis there was no change in the complication rates observed before and after ACERTO (10.7% vs. 7.7% (p=0.268) and there was a decrease in the length of hospitalization after ACERTO (8,5 vs. 6,1 dias (p=0.008). Conclusion: The implementation of the ACERTO project decreased the length of hospital stay, improved medical care provided without increasing the rates of complications evaluated.

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“…Os protocolos ERAS ou programas "fast-track", consistem num conjunto de medidas perioperatórias, com o objetivo de acelerar a recuperação pósoperatória da pessoa, diminuir o tempo de internamento e as complicações pós-operatórias (Soares & Soares, 2018;Steenhagen, 2015;Melnyk et al, 2011). O principal objetivo do conceito "fast-track", em cirurgia, também denominado ERAS ou cirurgia multimodal, é facilitar melhores condições cirúrgicas e obter uma recuperação mais rápida e alta hospitalar precoce, envolvendo estratégias de abordagem multidisciplinar para alterar as respostas fisiológicas e psicológicas como preparação para as grandes cirurgias (Ripollés-Melchor et al, 2018). et al, 2018), em particular os relacionados com o sistema cardiorrespiratório.…”

Section: Enquadramento/fundamentação Teóricaunclassified

(Re)educação funcional respiratória pré-operatória em pessoas com patologia colorretal: estudo observacional

Correia

Mendes

Areias

et al. 2022

RIIS

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Enquadramento: a cirurgia colorretal está associada ao risco de morbilidade e mortalidade, relacionando-se com o surgimento de complicações. Os exercícios de reeducação funcional respiratória (RFR) realizados por enfermeiros de reabilitação, tornam-se fundamentais para prevenir/minimizar complicações pós-operatórias. Objetivos: avaliar o impacto da RFR em pessoas com indicação para cirurgia colorretal, nos valores da capacidade vital (CV) e saturação periférica de O2 (SpO2) e descrever as capacidades adquiridas após a aplicação de um programa de RFR pré-operatório. Metodologia: estudo observacional descritivo, com amostra de conveniência de pessoas com patologia colorretal submetidas a um programa de RFR pré-operatória num Centro Hospitalar e Universitário da região centro de Portugal. Resultados: a amostra foi de 78 pessoas. Avaliados parâmetros respiratórios como a CV e SpO2, assim como a avaliação das capacidades adquiridas. A média de sessões de RFR por utente foi de 3,97, obtendo-se uma variação positiva da SpO2 em 46 e variação positiva da CV em 41. À exceção de 3 pessoas, a maioria adquiriu capacidades preconizadas a diferentes níveis. Conclusão: são visíveis ganhos obtidos na preparação pré-operatória das pessoas na função respiratória e nas capacidades para lidarem com a dor. Estes resultados são importantes para a prevenção de complicações respiratórias no período pós-operatório.

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Aceleração da recuperação após protocolo cirúrgico versus cuidados perioperatórios convencionais em cirurgia colorretal. Um estudo de coorte em centro único

Abstract: The implementation of ERAS protocol for colorectal surgery was associated with a significantly reduction of postoperative complications and length of stay.

Cited by 9 publications

References 36 publications

Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour

Colorectal Services in Covid-19 Times: Minimally Invasive Surgery and Enhanced Recovery, the Need of the Hour

Acerto Project: Impact on Assistance of a Public Emergency Hospital

(Re)educação funcional respiratória pré-operatória em pessoas com patologia colorretal: estudo observacional

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