Enhanced recovery after surgery: A consensus review of clinical care for patients undergoing colonic resection

Fearon, Kenneth C. H.; Ljungqvist, Olle; Meyenfeldt, Maarten von; Revhaug, Arthur; Dejong, C.H.C.; Lassen, Kristoffer; Nygren, Jonas; Hausel, Jonatan; Soop, Mattias; Andersen, Jens T.; Kehlet, Henrik

doi:10.1016/j.clnu.2005.02.002

Cited by 1,331 publications

(997 citation statements)

References 77 publications

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“…Enhanced recovery after surgery describes a multimodal perioperative care program 1, 22. Tubeless strategies are a major area of interest within the field of ERAS for thoracic surgery 23.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic air‐extraction strategy after thoracoscopic wedge resection

et al. 2018

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BackgroundSince the conception of enhanced recovery after surgery protocols, tubeless strategies have become popular. Herein, we introduce a previously unreported alternative air‐extraction strategy for patients who have undergone thoracoscopic wedge resection and explore its feasibility and safety.MethodsBetween January 2015 and June 2017, 264 consecutive patients underwent thoracoscopic wedge resection with different drainage strategies. Patients were divided according to the postoperative drainage strategies used: routine chest tube drainage (RT group), complete omission of chest tube drainage (OT group), and prophylactic air‐extraction catheter insertion procedure (PC group). Using the propensity score matching method, clinical parameters and objective operative qualities were compared among the three groups.ResultsOptimal 1:1 matching was used to form pairs of RT (n =36) and PC (n =36) groups and balance baseline characteristics among the three groups. The incidence rates of pneumothorax were 5.6% (2/36), 9.8% (5/51), and 19.4% (7/36) in the RT, OT, and PC groups, respectively (P = 0.07). Chest tube reinsertion incidence for postoperative pneumothorax was 19.4% (1/7) in the PC group and 60% (3/5) in the OT group. Other postoperative complications were comparable among these groups.ConclusionsThe prophylactic air‐extraction strategy may be an alternative procedure for selected patients. Remedial air extraction may reduce the occurrence of chest tube reinsertion for pneumothorax patients, but further investigation is required.

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“…Enhanced recovery after surgery describes a multimodal perioperative care program 1, 22. Tubeless strategies are a major area of interest within the field of ERAS for thoracic surgery 23.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic air‐extraction strategy after thoracoscopic wedge resection

et al. 2018

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“…Compared with traditional perioperative care, the Enhanced Recovery After Surgery (ERAS) programme represents a fundamental shift in the process of care, by including multiple interventions that attenuate surgical stress, maintain physiological function and expedite return to baseline 4. While each intervention has a small effect, all together they have a stronger synergistic impact (Fig.…”

Section: Figurementioning

confidence: 99%

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Scott

Baldini

Fearon

et al. 2015

Acta Anaesthesiol Scand

Self Cite

321

179

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BackgroundThe present article has been written to convey concepts of anaesthetic care within the context of an Enhanced Recovery After Surgery (ERAS) programme, thus aligning the practice of anaesthesia with the care delivered by the surgical team before, during and after surgery.MethodsThe physiological principles supporting the implementation of the ERAS programmes in patients undergoing major abdominal procedures are reviewed using an updated literature search and discussed by a multidisciplinary group composed of anaesthesiologists and surgeons with the aim to improve perioperative care.ResultsThe pathophysiology of some key perioperative elements disturbing the homoeostatic mechanisms such as insulin resistance, ileus and pain is here discussed.ConclusionsEvidence‐based strategies aimed at controlling the disruption of homoeostasis need to be evaluated in the context of ERAS programmes. Anaesthesiologists could, therefore, play a crucial role in facilitating the recovery process.

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“…A common goal in the development and implementation of an Enhanced Recovery After Surgery (ERAS) program has been the need to understand and identify the factors that keep patients in hospital longer than necessary and delay their return to baseline function. 2 When compared with traditional care, the ERAS programs represent a major change in the process of care, as each ERAS component addresses a specific physiologic target.…”

Section: Résumémentioning

confidence: 99%

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

Carli

2014

Can J Anesth/J Can Anesth

153

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Purpose Enhanced Recovery After Surgery (ERAS) programs have increasingly attracted the attention of clinicians who are intent on minimizing postoperative morbidity, decreasing variability in surgical care, and containing hospital costs. The purpose of this review is to discuss the relevant pathophysiology of the surgical stress response and its associated mechanisms that regulate important metabolic changes.

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Enhanced recovery after surgery: A consensus review of clinical care for patients undergoing colonic resection

Cited by 1,331 publications

References 77 publications

Prophylactic air‐extraction strategy after thoracoscopic wedge resection

Prophylactic air‐extraction strategy after thoracoscopic wedge resection

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

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