Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Lyu, Heather; Saadat, Lily V.; Bertagnolli, Monica M.; Wang, Jiping; Baldini, Elizabeth H.; Stopfkuchen-Evans, Matthias; Bleday, Ronald; Raut, Chandrajit P.

doi:10.1002/bjs.11758

Cited by 11 publications

(5 citation statements)

References 25 publications

(39 reference statements)

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“…It is important to note that the protocol does not have the structure, implementation, and evaluation of the ERAS ® guidelines. Lyu et al [11] first implemented the colorectal program in their center according to the official ERAS ® Society Guidelines and transferred this to sarcoma patients without relevant adaptations. An initial evaluation showed a reduction in complications and hospital length-of-stay.…”

Section: Disease-related Stratificationmentioning

confidence: 99%

Patient-Tailored Approach for Enhanced Recovery after Surgery

et al. 2022

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Background: Enhanced recovery after surgery (ERAS®) is increasingly finding its way into clinical practice. ERAS® protocols have not been universally adopted, and they have often been criticized for being difficult to implement. So, the question for more tailor-made approaches arises. Methods: We conducted a literature search on March 16, 2022, using the following search string, which was modified to fit the input of each of the queried databases: (“ERAS®” or “enhanced recovery after surgery” or “fast recovery” or “fast track”) and (“tailored” or “individual”). Results: Despite the massive increase in general hits on the subject, stratification according to phenotypic characteristics such as age or a classification according to disease patterns in the sense of specific guidelines is still fundamentally apparent. Evidence suggests that generic protocols can be followed by almost all patients. Prehabilitation, in particular, can be used as an adaptive tool. Conclusion: ERAS® works only in the totality of its tools and can be followed by almost all patients. Prehabilitation is more adaptive and can also increase adherence to ERAS® protocols. A tailored program outside of disease-specific pathways does not seem to be useful.

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Section: Disease-related Stratificationmentioning

confidence: 99%

Patient-Tailored Approach for Enhanced Recovery after Surgery

et al. 2022

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“…Применение принципов ускоренного восстановления после операции (ERAS) приводит к улучшению непосредственных результатов (IIIA). Так, в американском проспективном исследовании [26] 234 больных мягкоткаными саркомами, включая саркомы и забрюшинной (36) локализации, проходили лечение по программе ERAS.…”

Section: периоперационное ведение больныхunclassified

Modern strategy of treatment of patients with retroperitoneal sarcomas: A review

Стилиди

Никулин²,

Калинин³

et al. 2022

J. Mod. Onco.

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Retroperitoneal sarcomas are rare tumors of non epithelial origin. There are no standards of surgical treatment, chemotherapy or radiation. In 2021 Transatlantic Australasian RPS Working Group published consensus recommendation for diagnosis, treatment and follow-up of retroperitoneal sarcomas patients. The paper presents the main points of the consensus and discusses the surgical aspects of the recommendations, listing the histologic forms excluded from the retroperitoneal tumor group. The main strategy for surgical treatment is emphasized, which includes the necessity to remove retroperitoneal tumors en bloc as well as the necessity to consider the histological structure. Preoperative morphological examination of the tumor, specifying the subtype, should become a standard of examination of patients. The role of multidisciplinary advisory councils as a factor influencing the improvement of survival rate is pointed out. The experience of abdominal department interventions on the great vessels in the context of the experience of large surgical centers is presented. Topical issues of tumor non-resectability, chemotherapy and radiation therapy, perioperative management of patients, including the principles of accelerated recovery after surgery (ERAS) are considered. The results of preoperative irradiation of retroperitoneal sarcoma patients (STRASS1) are presented and the protocol of neoadjuvant therapy (STRASS2) is announced.

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“…With the popularization of the concept of enhanced recovery after surgery (ERAS) program (24), much attention has recently been given to modified surgical techniques that result in effective hemorrhage control, reduced postoperative pain, lower bedrest requirements, and shorter hospital stays (25)(26)(27)(28)(29). The modification of surgical approach is considered to be of major importance in the ERAS strategies.…”

Section: Introductionmentioning

confidence: 99%

Combined and Modified Gibson and Ilioinguinal Approaches in Type II + III Internal Hemipelvectomy for Periacetabular Tumors

Wang

et al. 2022

Front. Oncol.

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BackgroundThe routine iliofemoral approach and its modifications in type II+III resection require extensive skin incision and massive periacetabular muscle detachment, leading to prolonged hospital stay, increased complication incidence, and impaired lower limb function. Under the management of an enhanced recovery after surgery (ERAS) protocol, a combined and modified Gibson and ilioinguinal (MGMII) approach was used to avoid unnecessary soft tissue trauma during tumor resection and therefore advantageous to patients’ return to normal life.MethodsTwenty-five patients with type II + III (including type II) periacetabular tumors who underwent reconstruction with 3D printed customized endoprostheses at our center between January 2017 and March 2019 were included in this study. There were 13 cases using MGMII approach and 12 cases using iliofemoral approach. The operation duration and blood loss were assessed by chart review. The surgical margin was evaluated by the histopathological studies. The reconstruction accuracy, the abductor muscle strength, the 1993 version of the Musculoskeletal Tumor Society (MSTS-93), the Harris Hip scores (HHS), and the limp score were evaluated. Complications were recorded after reviewing the patients’ records.ResultsThe operative duration and blood loss in MGMII group were shorter than those in the iliofemoral group, but the postoperative hemoglobin was slightly higher than that in the iliofemoral group. The MGMII group had stronger postoperative hip abductors, better functional restoration, and relatively fewer patients with higher limp scores. No complication was observed in the MGMII group. In the iliofemoral group, three patients encountered wound healing delay, and one patient suffered deep infection.ConclusionsThe MGMII approach can better expose the posterior column of the acetabulum, especially the ischial tuberosity, which is beneficial for avoiding tumor rupture during resection. The MGMII approach also helps to preserve residual muscle function, such as the origin of the gluteus medius, while ensuring the extent of resection.

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Enhanced recovery after surgery pathway in patients with soft tissue sarcoma

Cited by 11 publications

References 25 publications

Patient-Tailored Approach for Enhanced Recovery after Surgery

Patient-Tailored Approach for Enhanced Recovery after Surgery

Modern strategy of treatment of patients with retroperitoneal sarcomas: A review

Combined and Modified Gibson and Ilioinguinal Approaches in Type II + III Internal Hemipelvectomy for Periacetabular Tumors

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