Eight years of experience with Enhanced Recovery After Surgery in patients with colon cancer: Impact of measures to improve adherence

Bakker, Nathalie; Cakir, Hamit; Doodeman, Hiëronymus J.; Houdijk, Alexander P. J.

doi:10.1016/j.surg.2015.01.016

Cited by 125 publications

(107 citation statements)

References 14 publications

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“…In the same sense, a study on the adherence rate to the ERAS protocol found that, during the years of higher compliance levels, the length of hospitalization dropped when compared to the low compliance periods. The implementation of the protocol reduced the fasting periods and contributed to other aspects that significantly improved the postoperative evolution, such as the reduction of the nasogastric tube use, early oral nutrition and early mobilization (12) . In another study that analyzed a control group that followed traditional fasting, being deprived of food and fluids and an intervention group that received fluids up to two hours before the surgery and solid foods up to six hours, it was verified that the intervention group showed less preoperative symptoms, such as hunger, headache and nausea, besides signs of feeling more comfortable (13) .…”

Section: The Projects Enhanced Recovery After Surgery (Eras) and The mentioning

confidence: 99%

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries

Pereira

Turrini

Poveda

2017

Rev. esc. enferm. USP

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Objective:To identify the length of perioperative fasting among patients submitted to gastrointestinal cancer surgeries. Method: Retrospective cohort study, developed by consulting the medical records of 128 patients submitted to gastrointestinal cancer surgeries. Results: The mean of total length of fasting was 107.6 hours. The total length of fasting was significantly associated with the number of symptoms presented before (p=0.000) and after the surgery (p=0.007), the length of hospital stay (p=0.000), blood transfusion (p=0.013), nasogastric tube (p=0.001) and nasojejunal tube (p=0,003), postoperative admission at ICU (p=0.002), postoperative death (p=0.000) and length of preoperative fasting (p=0.000). Conclusion: The length of fasting is associated with complications that affect the quality of the patients' postoperative recovery and nurses' work. The nursing team should be alert to this aspect and being responsible for overseeing the patients' interest, should not permit the unnecessary extension of fasting.

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Section: The Projects Enhanced Recovery After Surgery (Eras) and The mentioning

confidence: 99%

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries

Pereira

Turrini

Poveda

2017

Rev. esc. enferm. USP

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“…[1][2][3][4][5][6][7] It is well docu mented that ERAS is clinically effective as well as costeffective/cost-saving in that it reduces complications and health services utilization (HSU; e.g., length of stay in hospital [LOS]) without compromising patient safety and health-related quality of life (HRQoL). [8][9][10][11] A recent metaanalysis of 16 randomized controlled trials shows that ERAS significantly decreases primary LOS by 2.28 days and risk of complications by 40% in patients undergoing colorectal surgery.…”

mentioning

confidence: 99%

An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta

Thanh

Chuck

Wasylak

et al. 2016

cjs

112

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Background: In February 2013, Alberta Health Services established an Enhanced Recovery After Surgery (ERAS) implementation program for adopting the ERAS Society colorectal guidelines into 6 sites (initial phase) that perform more than 75% of all colorectal surgeries in the province. We conducted an economic evaluation of this initiative to not only determine its cost-effectiveness, but also to inform strategy for the spread and scale of ERAS to other surgical protocols and sites. Methods:We assessed the impact of ERAS on patients' health services utilization (HSU; length of stay [LOS], readmissions, emergency department visits, general practitioner and specialist visits) within 30 days of discharge by comparing pre-and post-ERAS groups using multilevel negative binomial regressions. We estimated the net health care costs/savings and the return on investment (ROI) associated with those impacts for post-ERAS patients using a decision analytic modelling technique. Results:We included 331 pre-and 1295 post-ERAS patients in our analyses. ERAS was associated with a reduction in all HSU outcomes except visits to specialists. However, only the reduction in primary LOS was significant. The net health system savings were estimated at $2 290 000 (range $1 191 000-$3 391 000), or $1768 (range $920-$2619) per patient. The probability for the program to be cost-saving was 73%-83%. In terms of ROI, every $1 invested in ERAS would bring $3.8 (range $2.4-$5.1) in return. Conclusion:The initial phase of ERAS implementation for colorectal surgery in Alberta is cost-saving. The total savings has the potential to be more substantial when ERAS is spread for other surgical protocols and across additional sites.Contexte : En février 2013, les Services de santé de l'Alberta ont mis en place le programme ERAS (Enhanced Recovery After Surgery -récupération postchirurgicale améliorée) dans le but de faire adopter les lignes directrices en matière d'interventions colorectales de la ERAS Society à 6 établissements (première phase) où sont pratiquées plus de 75 % des interventions chirurgicales colorectales de la province. Nous avons réalisé une évaluation économique du programme, non seulement pour en mesurer la rentabilité, mais aussi pour élaborer une stratégie visant à étendre le programme ERAS à d'autres protocoles chirurgicaux et services de chirurgie.Méthodes : Nous avons mesuré les effets du programme ERAS sur l'utilisation des services de santé (durée de séjour, réadmissions, visites au service des urgences, visites d'un omnipraticien ou d'un spécialiste) dans les 30 jours suivant le congé en comparant les groupes pré-et post-ERAS à l'aide de régressions binomiales négatives multiniveaux. Nous avons évalué le coût net des soins de santé, les économies réalisées et le rendement sur investissement (RSI) associés aux mesures ci-dessus chez les patients post-ERAS à l'aide d'une technique de modélisation analytique décisionnelle.Résultats : Nos analyses ont porté sur 331 patients pré-ERAS et 1295 patients post-ERAS. Nous avons observé une...

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“…Thirteen articles published between 2012 and 2015 met our proposed inclusion criteria 14,17,18‐28 . In 2013, four of these articles (30.8%) were published 20,23,24,27 .…”

Section: Purpose and Objectivesmentioning

confidence: 99%

“…In 2013, four of these articles (30.8%) were published 20,23,24,27 . Among the articles we reviewed, the World Journal of Surgery published four studies (30.8%), 17,20,21,24 and the remaining journals published one study each 14,18,19,22,23,25‐28 . All studies included were published in English and the primary author was a physician.…”

Section: Purpose and Objectivesmentioning

confidence: 99%

An Integrative Review of Postoperative Accelerated Recovery Protocols

Oliveira¹,

Guatura²,

Peniche³

et al. 2017

AORN Journal

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We undertook an integrative literature review of articles pertaining to perioperative nursing care provided to patients using postoperative accelerated recovery protocols. To select the articles, we searched the MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature, and LiteraturaLatino-Americana e do Caribe em Ciências da Saúde databases. We identified 329 studies, 13 of which met our inclusion criteria and described perioperative nursing care activities. Nursing activities noted in these articles were hypothermia prevention and maintenance of normothermia, restriction of IV fluids, assessment of vital signs, management of symptoms and pain, support of early ambulation, care for tubes and drains, oral administration of carbohydrate-rich foods, assessment of ability to tolerate diet, and encouragement to resume activities of daily living. There was a lack of research on this topic by nursing professionals; additional research by nursing professionals is needed regarding nurses' roles in providing this care.

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Eight years of experience with Enhanced Recovery After Surgery in patients with colon cancer: Impact of measures to improve adherence

Cited by 125 publications

References 14 publications

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries

An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta

An Integrative Review of Postoperative Accelerated Recovery Protocols

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