Aktuelle Studienlage der Enhanced Recovery After Surgery (ERAS®) nach radikaler Zystektomie

Schulz, Gerald Bastian; Volz, Yannic; Jokisch, Friedrich; Casuscelli, Jozefina; Eismann, Lennert; Pfitzinger, Paulo; Stief, Christian G.; Schlenker, Boris

doi:10.1007/s00120-020-01435-y

Cited by 6 publications

(3 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The use of early home transfer pathways is clearly increasing, as they allow early patient recovery with complication rates comparable to standard care. [19][20][21][22][23][24] However, some surgeons consider that their application remains limited, especially because of concerns about postoperative complications during early home transfer. 21,22 When comparing our cohort with other cystectomy ERAS series without HaH, no significant differences in LOS, antibiotic use, and complications were found.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21][22][23][24] However, some surgeons consider that their application remains limited, especially because of concerns about postoperative complications during early home transfer. 21,22 When comparing our cohort with other cystectomy ERAS series without HaH, no significant differences in LOS, antibiotic use, and complications were found. 23 Furthermore, when analyzing hospital readmission rates, percentages are higher in those cohorts, which could indicate less postoperative surveillance at discharge.…”

Section: Discussionmentioning

confidence: 99%

“…The use of early home transfer pathways is clearly increasing, as they allow early patient recovery with complication rates comparable to standard care 19–24 . However, some surgeons consider that their application remains limited, especially because of concerns about postoperative complications during early home transfer 21,22 .…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness and Safety of Postoperative Hospital at Home for Surgical Patients

Ugarte,

Bachero,

Cucchiari

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

Objective: To determine the feasibility and effectiveness of a Hospital at Home (HaH) enabled early transfer pathways for surgical patients. Background: HaH serves as a safe alternative to traditional hospitalization by providing acute care to patients in their homes through a comprehensive range of hospital-level interventions. To our knowledge, no studies have been published to date reporting a large cohort of early home transferred patients after surgery through a HaH unit. Methods: Cohort study enrolling every patient admitted to the HaH unit of a tertiary hospital who underwent any of six surgeries with a predefined early transfer pathway and fitting both general and surgery inclusion criteria (clinical and hemodynamic stability, uncomplicated surgery, presence of a caregiver, among others) from November 2021 to May 2023. Protocols were developed for each pathway between surgical services and HaH to deliver the usual postoperative care in the home setting. Discharge was decided according to protocol. An urgent escalation pathway was also established. Results: During the study period, 325 patients were included; 141 were bariatric surgeries, 85 kidney transplants, 45 thoracic surgeries, 37 cystectomies, 10 appendicectomies and 7 ventral hernia repairs. Overall escalation of care during HaH occurred in 7.3% of patients and 30-days readmissions in 7%. Most adverse events were managed at home and the overall mortality was zero. Total mean LOS was 8 days (IQR 2-14) and patients with HaH were transferred home 3 days (IQR 1-6) earlier than the usual pathway; a total of 1,551 bed-days were saved. Conclusions: The implementation of early home transfer pathways for surgical patients through HaH is feasible and effective, with favorable safety outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness and Safety of Postoperative Hospital at Home for Surgical Patients

Ugarte,

Bachero,

Cucchiari

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

show abstract

Die minimal-invasive Chirurgie beim Blasenkarzinom – Vorteile und neue Entwicklungen

et al. 2022

View full text Add to dashboard Cite

Enhanced recovery after surgery: Progress in adapted pathways for implementation in standard and emerging surgical settings

Wishahi,

Kamal,

Hedaya

2024

World J Clin Cases

View full text Add to dashboard Cite

The concept of enhanced recovery after surgery (ERAS) has been practiced for decades and has been implemented in numerous surgical specialties. ERAS is a global surgical quality improvement initiative, and it is an element in the field of perioperative care. ERAS had shown significant clinical outcomes, patient-reported satisfaction, and improvements in medical service cost. ERAS has been developed for specific surgical procedures, but with the fast progress of newly introduced surgical procedures, the original ERAS have been developed and modified. Recently appearing Topics and future research trends encompass ERAS protocols for other types of surgery and the enhancement of perioperative status, including but not limited to pediatric surgery, laparoscopic and robotic assisted surgery, bariatric surgery, thoracic surgery, and renal transplantation. The elements and pathways of ERAS have been developed with the introduction of up-to-date methodologies in the pre-operative, operative, and post-operative pathways. ERAS costs are higher than traditional care, but the patient’s clinical outcome and satisfaction are higher. ERAS is in progress in the fields of anesthetic tasks, pediatric surgery, and organ transplantation. Although ERAS has shown significant clinical outcomes, there are needs to modify the protocol for specific cases, hospital facilities, resources, and nurses training on elements of ERAS. Several challenges and limitations exist in the implementation of ERAS that deserve consideration, it includes: Frailty, maximizing nutrition, prehabilitation, treating preoperative anemia, and enhancing ERAS adoption globally are all included.

show abstract

Aktuelle Studienlage der Enhanced Recovery After Surgery (ERAS®) nach radikaler Zystektomie

Cited by 6 publications

References 39 publications

Effectiveness and Safety of Postoperative Hospital at Home for Surgical Patients

Effectiveness and Safety of Postoperative Hospital at Home for Surgical Patients

Die minimal-invasive Chirurgie beim Blasenkarzinom – Vorteile und neue Entwicklungen

Enhanced recovery after surgery: Progress in adapted pathways for implementation in standard and emerging surgical settings

Contact Info

Product

Resources

About