Evidence-Based Anesthesia for Major Gynecologic Surgery

Bauchat, Jeanette R.; Habib, Ashraf S.

doi:10.1016/j.anclin.2014.11.011

Cited by 28 publications

(27 citation statements)

References 150 publications

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“…Patients undergoing surgery in the ERAS pathway had comparable pain scores, but lower opioid use compared with those in the pre-ERAS group. The avoidance of opioid narcotics, and replacement with a standardized EDA and non-narcotic multimodal pain regimen, has multiple potential benefits 14,18 -20 . For example, avoiding the use of opioids can improve postoperative bowel function and oral intake, thereby expediting return to baseline function 18,19 . Furthermore, there is growing evidence that opioids may be detrimental to patients with cancer.…”

Section: Discussionmentioning

confidence: 99%

Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection

Page

Gani

Crowley

et al. 2016

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection

Page

Gani

Crowley

et al. 2016

British Journal of Surgery

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“…Our institutional ERP was published in 2017 [4] and is in accordance with the latest published recommendations [5,[11][12][13][14]. The main pathways of the ERP are summarized in Fig 1. Consecutive patients undergoing minimally invasive procedures (hysterectomy and/or pelvic or para-aortic lymphadenectomy) either by RAL or CL for gynecologic cancers (cervical, endometrial or ovarian cancer) were identified.…”

Section: Methodsmentioning

confidence: 97%

Choosing the most appropriate minimally invasive approach to treat gynecologic cancers in the context of an enhanced recovery program: Insights from a comprehensive cancer center

et al. 2020

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The aim of the study was to compare the characteristics of procedures for gynecologic cancers conducted with conventional laparoscopy (CL) or robotically assisted laparoscopy (RAL) in the context of an enhanced recovery program (ERP). Methods This is a secondary analysis of prospectively collected data from a cohort study conducted between 2016 (when the ERP was first implemented at the Institut Paoli-Calmettes, a comprehensive cancer center in France) and 2018. We included patients who had undergone minimally invasive surgery for gynecological cancers and followed our ERP. The endpoints were the analysis of postoperative complications, the length of postoperative hospitalization (LPO), and the proportion of combined procedures depending on the approach (RAL or CL). Combined procedures were defined by the association of at least two of the following operative items: hysterectomy, pelvic lymphadenectomy, and para-aortic lymphadenectomy. Results A total of 362 women underwent either CL (n = 187) or RAL (n = 175) for gynecologic cancers and followed our ERP. The proportion of combined procedures performed by RAL was significantly higher (85/175 [48.6%]) than that performed by CL (23/187 [12.3%]; p < 0.001). The proportions of postoperative complications were similar between the two groups (19.4% versus 17.1%; p = 0.59). Logistic regression analysis revealed a statistically

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“…[76] ERAS is an evidenced-based multidisciplinary approach to perioperative care delivery aimed at improving early recovery of patients undergoing major surgery. Components of ERAS programs include multimodal analgesia and anesthesia in the perioperative period, early feeding and ambulation, goal directed fluid therapy, as well as avoidance of routine drain or nasogastric tube placement.…”

Section: Factors Influencing Loco-regional and Distant Metastatic Dismentioning

confidence: 99%

Fundamental Principles of Cancer Biology: Does It Have Relevance to the Perioperative Period?

Jiang

Nick

Sood

2015

Curr Anesthesiol Rep

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Malignant tumors are characterized by their ability to metastasize, which is the main cause of cancer-related mortality. Besides intrinsic alternations in cancer cells, the tumor microenvironment plays a pivotal role in tumor growth and metastasis. Ample evidence suggests that the perioperative period and the excision of the primary tumor can promote the development of metastases and can influence long-term cancer patient outcomes. The role of cancer biology and its impact on the perioperative period are of increasing interest. This review will present evidence regarding fundamental principles of cancer biology, especially tumor microenvironment, and discuss new therapeutic opportunities in the perioperative timeframe. We will also discuss the regulatory signaling that could be relevant to various aspects of surgery and surgical responses, which could facilitate the metastatic process by directly or indirectly affecting malignant tissues and the tumor microenvironment. We address the influences of surgery-related stress, anesthetic and analgesic agents, blood transfusion, hypothermia, and β-adrenergic blockade administration on tumor growth and metastasis. Through an improved understanding of these processes, we will provide suggestions for potential new perioperative approaches aimed at improving treatment outcomes of cancer patients.

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Evidence-Based Anesthesia for Major Gynecologic Surgery

Cited by 28 publications

References 150 publications

Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection

Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection

Choosing the most appropriate minimally invasive approach to treat gynecologic cancers in the context of an enhanced recovery program: Insights from a comprehensive cancer center

Fundamental Principles of Cancer Biology: Does It Have Relevance to the Perioperative Period?

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