Enhanced Recovery After Surgery (ERAS<sup>®</sup>) in Individuals with Diabetes: A Systematic Review

Albalawi, Zaina; Laffin, Michael; Gramlich, Leah; Senior, Peter; McAlister, Finlay A.

doi:10.1007/s00268-017-3982-y

Cited by 26 publications

(15 citation statements)

References 92 publications

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“…A systematic review of MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, conference proceedings and ongoing clinical trials yielded no such high-quality articles that included patients with diabetes undergoing ERAS surgery. 8 In spite of differences in age and premorbid status, our findings showed that there is no difference in outcomes between patients with prior diagnosis of DM and those without under ERAS. The ERAS protocol has multiple interventions that may contribute to reducing length of stay.…”

Section: Limitations Of the Study And Recommendationsmentioning

confidence: 45%

“…The published randomized controlled trials that support ERAS interventions have excluded patients with DM or have included them only in very small numbers. 7,8 A guideline from the United Kingdom recommended the exclusion of patients with a history of diabetes from ERAS programmes, particularly because of the lack of data among patients with diabetes who have undergone ERAS surgery. 9 However, ERAS consensus statements recommend that patients with diabetes may be included provided that their conditions are optimized to international standards.…”

Section: Introductionmentioning

confidence: 99%

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Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

Festejo-Villamiel¹,

Yao²,

Sioson³

2019

JAFES

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Objective. To determine whether a prior diagnosis of diabetes mellitus (DM) is associated with longer postoperative length of stay (LOS) and higher complication rates among patients who underwent colorectal surgery under an Enhanced Recovery After Surgery (ERAS) protocol in a single hospital setting.Methodology. In a cross-sectional study, we grouped 157 consecutive patients who underwent elective colorectal surgery under ERAS protocol according to preoperative DM status. Patient data was abstracted from the ERAS Interactive Audit Database from January 2016 to December 2017. We compared LOS between groups. Secondary outcomes were postoperative complications, reoperations, pneumonia and wound infection. Categorical and continuous variables were analyzed with Fisher's exact test and student's t-test, respectively, using Stata/SE version 13 with a significance level of p=0.05.Results. One hundred thirteen subjects did not have diabetes (no T2DM) while 44 patients had type 2 diabetes mellitus (T2DM). Mean postoperative length of hospital stay was 6.4±5.1 days for the no T2DM group versus 5.8±3.8 in the T2DM group (p=0.476). Complications, reoperation rate, pneumonia and wound infection did not differ between groups. Among subjects in the T2DM group, LOS did not differ between patients with preoperative HbA1c ≤7.0% and those with HbA1c >7.0% (5.7±3.7 versus 6.1±4.2 days, p=0.748). Conclusion.Among patients who underwent colorectal surgery under ERAS protocol, a prior diagnosis of diabetes was not associated with longer LOS or more complications. A preoperative HbA1c of <7% did not affect length of stay in ERAS among patients with T2DM.

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Section: Limitations Of the Study And Recommendationsmentioning

confidence: 45%

Section: Introductionmentioning

confidence: 99%

Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

Festejo-Villamiel¹,

Yao²,

Sioson³

2019

JAFES

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“…The NICOM works similarly to the EDM in assessing GDFT, with no clinically significant differences in results, and offers more easy practice as well as fewer missing data points. In our study, the target blood glucose level for the perioperative period was 80-180 mg/dl and was controlled by the basal-bolus insulin regimens which are recommended over sliding scale regimens.Similarly, did Albalawi et al [17]in their study about the effect of ERAS in individuals with diabetes.…”

Section: Discussionmentioning

confidence: 88%

“…[16] Individuals with diabetes are a high-risk surgical population, and despite advances in perioperative care with the introduction of the ERAS program, it is unknown whether postoperative outcomes are altered by enrollment in an ERASprogram compared to conventional care. [17] Therefore, our aim in the study was to apply the ERAS program in diabetic patients undergoing radical cystectomy and shortening the length of hospital stay and first bowel motion.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of enhanced recovery protocol from anesthesia in diabetic patients undergoing radical cystectomy

Ammar

Areda

Abbady

et al. 2021

Alexandria Journal of Medicine

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Background: Prevalence of diabetes in surgical patients is 10-40%. They have higher incidence of complications, and longer stay in hospital compared to non-diabetic. Radical cystectomy with urinary diversion is considered one of the high-risk surgeries associated with morbidity and mortality. Enhanced recovery after surgery (ERAS) is an evidence-based multimodal surgical care protocol that improves post-operative outcomes and length of stay (LOS) in patients without diabetes. This study evaluates the evidence on whether diabetic patientswould benefit from ERAS pathway. The aim of the study: was to evaluate the efficacy of ERAS protocol from anesthesia in diabetic patients undergoing radical cystectomy. Patients and methods: This study was carried out in Alexandria main University Hospital on fifty-four adult ASA physical status I, II and III participants of either sex. Participants were scheduled for radical cystectomy surgeries under the effect of general anesthesia, following ERAS protocol, divided into two group diabetic and non-diabetic27 participants each. The ICON device was used to measure the stroke volume variation (SVV) to apply goal-directed fluid therapy (GDFT) for all patients. Measurements: Demographic data, hemodynamic parameters (stoke volume, cardiac index), intra-operative fluid requirement, blood loss, postoperative pain intensity, time of first bowel movement, PH, Bicarbonate level, serum lactate level, heamatocrit and LOS were measured and recorded. Main results: No statistical significant difference was detected between both groups as regard age, sex, weight, vital signs, serum lactate, first bowel movement and VAS. There was statistical significant difference between both groups as regard fluid requirement, and the days of hospital stay. Conclusion:ERAS is a beneficial protocol to improve postoperative outcome in radical cystectomy surgeries, it can be used in diabetic patients to decrease postoperative morbidity and mortality.

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“…In recent years, anesthesiologists play a key role in those perioperative care coordination (15,16). ERAS protocols consist of multimodal perioperative managements developed to reduce complications and length of stay after surgery by maintenance of preoperative organ function and reduction of postoperative stress response (17). The shortening of preoperative fasting has proposed to replace fasting patient from the midnight without increase in aspiration risk (18).…”

Section: Preoperative Preparation Following Enhanced Recovery After Smentioning

confidence: 99%

Preoperative, intraoperative and postoperative anesthetic prospective for thyroid surgery: what’s new

Lu¹,

Lin²,

Wu³

et al. 2017

Gland Surg.

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The aim of this review is to analyze what's new on anesthetic prospective to perioperative management for thyroid surgery. For recent decades intraoperative neuromonitoring (IONM) during thyroid and parathyroid surgery has obtained more and more popularity. New modality of anesthetic technique was also developed to incorporate into surgical teamwork. For example, the precise position of EMG tube and optimal use of neuromuscular blocking agents (NMBAs) play key roles in successful IONM system. Special focus is paid to following issues: (I) preoperative airway evaluation and pre-op preparation; (II) anesthetic managements including advanced intubation tools, NMBAs and sugammadex; and (III) post-op adverse events such as pain and postoperative nausea vomiting.

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Enhanced Recovery After Surgery (ERAS^®) in Individuals with Diabetes: A Systematic Review

Abstract: To date, the effects of ERAS on patients with diabetes have not been rigorously evaluated. This review highlights the lack of evidence in this area and provides guidance on design for future studies.

Cited by 26 publications

References 92 publications

Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

The efficacy of enhanced recovery protocol from anesthesia in diabetic patients undergoing radical cystectomy

Preoperative, intraoperative and postoperative anesthetic prospective for thyroid surgery: what’s new

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Enhanced Recovery After Surgery (ERAS®) in Individuals with Diabetes: A Systematic Review

Abstract: To date, the effects of ERAS on patients with diabetes have not been rigorously evaluated. This review highlights the lack of evidence in this area and provides guidance on design for future studies.

Cited by 26 publications

References 92 publications

Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

Enhanced Recovery after Surgery (ERAS®) Outcomes in Patients with Prior Diagnosis of Diabetes

The efficacy of enhanced recovery protocol from anesthesia in diabetic patients undergoing radical cystectomy

Preoperative, intraoperative and postoperative anesthetic prospective for thyroid surgery: what’s new

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Product

Resources

About

Enhanced Recovery After Surgery (ERAS^®) in Individuals with Diabetes: A Systematic Review