Ambulatory latissimus dorsi flap breast reconstruction: A prospective cohort study of an enhanced recovery after surgery (ERAS) protocol

Stein, Michael J.; Frank, Simon G.; Lui, Anne; Zhang, Tinghua; Zhang, Jing

doi:10.1016/j.bjps.2019.06.039

“…As proposed by Henrik Kehle, a Danish surgeon, ERAS is a multidisciplinary and multiprofessional approach for postoperative patients to obtain a relatively rapid recovery [25]. To date, the basic principles of ERAS have been adopted by surgical specialties in multiple fields [26,27].…”

Section: Discussionmentioning

confidence: 99%

Enhanced Recovery after Surgery Protocol Accelerates Recovery of Lumbar Disc Herniation among Elderly Patients Undergoing Discectomy via Promoting Gastrointestinal Function

Zuo

¹

,

Wang

²

,

He

³

et al. 2021

Pain Research and Management

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This study aimed to analyze the effect of the enhanced recovery after surgery (ERAS) protocol on the recovery of gastrointestinal function in patients with lumbar disc herniation after discectomy. A total of 179 patients with lumbar disc herniation were randomly divided into the ERAS and non-ERAS groups. The non-ERAS group received routine nursing, and the ERAS group received ERAS strategy. The two groups were compared for general recovery indicators such as postoperative hemoglobin and prealbumin, satisfaction, and length of hospital stay. Gastrointestinal function was also evaluated, such as postoperative feeding time, intestinal chirping recovery time, intestinal exhaust gas recovery time, and complications such as ileus, nausea, and vomiting. The satisfaction of patients in the ERAS group (86.15 ± 2.43) was significantly higher than that in the non-ERAS group (77.19 ± 3.32), and the difference was statistically significant ( P < 0.05 ). The average time of eating in the ERAS group was 2.27 h after surgery. In addition, the amount of eating in the ERAS group was significantly better than that in the non-ERAS group, and the difference was statistically significant. In the ERAS group, intestinal chirping recovery time recovered to normal time, and exhaust recovery time and average defecation time were significantly shorter than those in the non-ERAS group. In the ERAS group, the average amount of hemoglobin and prealbumin decreased 3 days after operation, which was significantly lower than that in the non-ERAS group. To sum up, ERAS has an evident effect on the recovery of gastrointestinal function after discectomy of disc herniation, which can promote the recovery of patients.

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“…Initially proposed by Danish surgeon, Henrik Kehle, ERAS is a multi-professional and multidisciplinary approach to the care of the surgical patient in order to obtain a rapid recovery after surgical intervention [11]. While the initial efforts focused on colorectal surgery, the basic principles have now been adopted to multiple surgical specialties [6,[12][13][14]. ERAS protocols have been shown to be particularly beneficial for the elderly people who often have comorbidities and run a higher risk of surgical complications.…”

Section: Discussionmentioning

confidence: 99%

Enhanced recovery after surgery (ERAS) program for elderly patients with short-level lumbar fusion

Wang

¹

,

Wei

²

,

Kong

³

et al. 2020

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Background: Degenerative disorders of the lumbar spine decrease the mobility and quality of life of elderly patients. Lumbar fusion surgery is the primary method of treating degenerative lumbar spine disorders; however, the surgical stress response associated with major surgery has been linked to pathophysiological changes in the elderly, resulting in undesirable postoperative morbidity, complications, pain, fatigue, and extended convalescence. In the present study, we aimed to determine whether enhanced recovery after surgery significantly improved satisfaction and outcomes in elderly patients (> 65 years old) with short-level lumbar fusion. Methods: The study enrolled lumbar disc herniation or lumbar spinal stenosis patients if they were over the age of 65 years old underwent lumbar fusion at one or two levels. Data including demographic, comorbidity, and surgical information were collected from electronic medical records. Enhanced recovery after surgery interventions was categorized as preoperative, intraoperative, and postoperative. We also evaluated primary outcome, surgical complication, length of stay, postoperative pain scores, and 30-day readmission rates.

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“…Worley et alfound that patients age 65 had an increasedrisk of inpatient morbidity (10).Initially proposed by Danish surgeon, Henrik Kehle, ERAS is a multi-professional and multidisciplinary approach to the care of the surgical patientin order to obtain a rapid recovery after surgical intervention (11). While the initial efforts focused on colorectal surgery,the basic principles now been adopted to multiple surgical specialties (6,(12)(13)(14). ERAS protocols have beenshown to be particularly bene cial for the elderly people who often haveco-morbidities and run a higher risk of surgical complications.Furthermore, these principleshave been applied in patients withtotal hip arthroplasty, total knee arthroplasty, and those with intertrochanteric fracture, who notnot only experiencedreduced hospital LOS, but also in improvement in patient care and reduced health care costs (15,16).…”

Section: Discussionmentioning

confidence: 99%

Enhanced Recovery After Surgery (Eras) Program for Elderly Patients With Short-level Lumbar Fusion

Wang

¹

,

Wang

²

,

Kong

³

et al. 2020

Preprint

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Background:Degenerative disorders of the lumbar spinedecrease the mobility and quality of life of elderly patients.Lumbar fusion surgery is the primary methodof treating degenerative lumbar spine disorders; however, the surgical stress response associated with major surgery has been linked to pathophysiological changes in the elderly,resulting in undesirable postoperative morbidity, complications, pain, fatigue, and extended convalescence. In the present study, we aimed to determine whether enhanced recovery after surgery (ERAS) significantly improvedsatisfaction and outcomes in elderly patients(>65 years old) with short-level lumbar fusion.Methods:A total of 192 patients were included, 96 in the ERAS group and 96 case-matched patients in the non-ERAS group.Data including demographic, comorbidity and surgical informationwere collected from electronic medical records. ERAS interventionswere categorisedas preoperative,intraoperative and postoperative. We also evaluated primary outcome,surgicalcomplication, length of stay (LOS), postoperative pain scores and 30-day readmissionrates.Results:There were no statistically significant intergroup differences in regards to demographics, comorbidities、American Society of Anaesthesiologists (ASA) grade、or the number of fusion levels. There were also no differences between mean surgery time of intraoperative blood loss between the ERAS and non-ERAS groups. In addition, the mean preoperative Japanese Orthopaedic Association (JOA) score、Visual Analogue Score (VAS) for the back and legs and Oswestry Disability Index (ODI) score were not significantly different between the two groups. Overall, ERAS pathway compliance was 92.1%. There were no significant differences inthe number of complicationsor themortality rates between the ERAS and non-ERAS groups. Furthermore, the mean postoperative JOA score、VAS for the back and legs,ODI and readmission ratesscore revealed no significant differencesbetween the groups at 30-day- follow-up point. However, we observed a statistically significant decrease in LOS in the ERAS group (12.30±3.03 of ERAS group versus 15.50±1.88 in non-ERAS group, p=0).Multivariable linear regression showed thatcomorbidities (p=0.023) and implementation of ERAS program (p=0.002) were correlated with prolonged LOS.Multivariable logistic regression showed that no characteristics were associated with complications.Conclusions:This report describes the first ERAS protocol used in elderly patients after short-level lumbar fusion surgery. Our ERAS program is safe and could help decreases LOS in elderly patients with short-level lumbar fusion.

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Ambulatory latissimus dorsi flap breast reconstruction: A prospective cohort study of an enhanced recovery after surgery (ERAS) protocol

Cited by 27 publications

References 13 publications

Enhanced Recovery after Surgery Protocol Accelerates Recovery of Lumbar Disc Herniation among Elderly Patients Undergoing Discectomy via Promoting Gastrointestinal Function

Enhanced Recovery after Surgery Protocol Accelerates Recovery of Lumbar Disc Herniation among Elderly Patients Undergoing Discectomy via Promoting Gastrointestinal Function

Enhanced recovery after surgery (ERAS) program for elderly patients with short-level lumbar fusion

Enhanced Recovery After Surgery (Eras) Program for Elderly Patients With Short-level Lumbar Fusion

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