Efficacy and Safety of Enhanced Recovery After Surgery Pathway in Minimally Invasive Colorectal Cancer Surgery: A Systemic Review and Meta-Analysis

Li, Niu; Liu, Yanbiao; Chen, Huijuan; Sun, Yefei

doi:10.1089/lap.2022.0349

Cited by 5 publications

(2 citation statements)

References 50 publications

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“…Clinical variables affecting global HRQoL are not easy to modify, but consistent efforts to reduce recurrence have improved long-term outcomes. In particular, postoperative ileus has been addressed by systematic efforts for early mobilisation, and bowel obstruction has been improved over time through the increased use of laparoscopic surgery [ 33 – 35 ].…”

Section: Discussionmentioning

confidence: 99%

Developing a multivariable prediction model of global health-related quality of life in patients treated for rectal cancer: a prospective study in five countries

Andersson,

Angenete,

Gellerstedt

et al. 2024

Int J Colorectal Dis

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Purpose Rectal cancer and its treatment have a negative impact on health-related quality of life (HRQoL). If risk factors for sustained low HRQoL could be identified early, ideally before the start of treatment, individualised interventions could be identified and implemented to maintain or improve HRQoL. The study aimed to develop a multivariable prediction model for global HRQoL 12 months after rectal cancer treatment. Methods Within COLOR II, a randomised, multicentre, international trial of laparoscopic and open surgery for rectal cancer, a sub-study on HRQoL included 385 patients in 12 hospitals and five countries. The HRQoL study was optional for hospitals in the COLOR II trial. EORTC QLQ-C30 and EORTC QLQ-CR38 were analysed preoperatively and at 1 and 12 months postoperatively. In exploratory analyses, correlations between age, sex, fatigue, pain, ASA classification, complications, and symptoms after surgery to HRQoL were studied. Bivariate initial analyses were followed by multivariate regression models. Results Patient characteristics and clinical factors explained 4–10% of the variation in global HRQoL. The patient-reported outcomes from EORTC QLQ-C30 explained 55–65% of the variation in global HRQoL. The predominant predictors were fatigue and pain, which significantly impacted global HRQoL at all time points measured. Conclusion We found that fatigue and pain were two significant factors associated with posttreatment global HRQoL in patients treated for rectal cancer T1-T3 Nx. Interventions to reduce fatigue and pain could enhance global HRQoL after rectal cancer treatment. Trial registration This trial is registered with ClinicalTrials.gov No. NCT00297791

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Section: Discussionmentioning

confidence: 99%

Developing a multivariable prediction model of global health-related quality of life in patients treated for rectal cancer: a prospective study in five countries

Andersson,

Angenete,

Gellerstedt

et al. 2024

Int J Colorectal Dis

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“…Die vorliegende Evidenz unterstreicht die Notwendigkeit für Kliniker, ▪ geriatrische Assessments in die tägliche Praxis zu implementieren, ▪ die zentrale Rolle der Prähabilitation und ▪ die Bedeutung von ERAS-Konzepten [35]. Merke Zu den operativen Herausforderungen zählt die zeitnahe und belastungsstabile Versorgung von Frakturen.…”

Section: Onkologische Operationunclassified

Chirurgie im hohen Lebensalter

Knoblauch,

Saller,

Renz

2024

Intensivmedizin up2date

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Same-day discharge (SDD) vs standard enhanced recovery after surgery (ERAS) protocols for major colorectal surgery: a systematic review

Zheng

Wee

Abdullah

et al. 2023

Int J Colorectal Dis

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Background Enhanced recovery after surgery (ERAS) programs are well-established, resulting in improved outcomes and shorter length of hospital stay (LOS). Same-day discharge (SDD), or “hyper-ERAS”, is a natural progression of ERAS. This systematic review aims to compare the safety and efficacy of SDD against conventional ERAS in colorectal surgery. Methods The protocol was prospectively registered in PROSPERO (394793). A systematic search was performed in major databases to identify relevant articles, and a narrative systematic review was performed. Primary outcomes were readmission rates and length of hospital stay (LOS). Secondary outcomes were operative time and blood loss, postoperative pain, morbidity, nausea or vomiting, and patient satisfaction. Risks of bias was assessed using the ROBINS-I tool. Results Thirteen studies were included, with five single-arm and eight comparative studies, of which one was a randomised controlled trial. This comprised a total of 38,854 patients (SDD: 1622; ERAS: 37,232). Of the 1622 patients on the SDD pathway, 1590 patients (98%) were successfully discharged within 24 h of surgery. While most studies had an overall low risk of bias, there was considerable variability in inclusion criteria, types of surgery or anaesthesia, and discharge criteria. SDD resulted in a significantly reduced postoperative LOS, without increasing risk of 30-day readmission. Intraoperative blood loss and postoperative morbidity rates were comparable between both groups. Operative duration was shorter in the SDD group. Patient-reported satisfaction was high in the SDD cohort. Conclusion SDD protocols appear to be safe and feasible in selected patients undergoing major colorectal operations. Randomised controlled trials are necessary to further substantiate these findings.

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Efficacy and Safety of Enhanced Recovery After Surgery Pathway in Minimally Invasive Colorectal Cancer Surgery: A Systemic Review and Meta-Analysis

Cited by 5 publications

References 50 publications

Developing a multivariable prediction model of global health-related quality of life in patients treated for rectal cancer: a prospective study in five countries

Developing a multivariable prediction model of global health-related quality of life in patients treated for rectal cancer: a prospective study in five countries

Chirurgie im hohen Lebensalter

Same-day discharge (SDD) vs standard enhanced recovery after surgery (ERAS) protocols for major colorectal surgery: a systematic review

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