Feasibility and outcomes of modified enhanced recovery after surgery for nursing management of aged patients undergoing esophagectomy

Li, Wei; Zheng, Bin; Zhang, Shuliang; Chen, Hao; Zheng, Wei; Chen, Chun

doi:10.21037/jtd.2017.11.110

Cited by 15 publications

(11 citation statements)

References 19 publications

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“…After initial evaluation, 597 studies were removed for being duplicates, 2204 for being irrelevant (as determined by reading the abstracts), and 67 studies were excluded for reasons determined by reading the full text (Additional file 2). 16 studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] were included in the final meta-analysis. Figure 1 shows the work flow for the selection of studies.…”

Section: Literature Identificationmentioning

confidence: 99%

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

et al. 2020

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Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods: Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results: A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR = 0.50, 95%CI: 0.33 to 0.75), postoperative length of stay (MD =-2.53, 95%CI: − 3.42 to − 1.65), time until first postoperative flatus (MD =-0.64, 95%CI: − 0.84 to − 0.45) and time until first postoperative defecation (MD =-1.10, 95%CI: − 1.74 to − 0.47) in patients who received ERAS, compared to conventional care. However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P = 0.10), surgical site infection (P = 0.42), postoperative anastomotic leakage (P = 0.45), readmissions (P = 0.31) and ileus (P = 0.25). Conclusions: ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

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Section: Literature Identificationmentioning

confidence: 99%

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

et al. 2020

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“…However, conclusions from this review were less definitive due to virtually no randomized trials being included. Thus, the benefits of ERAS in esophageal surgery are still debatable (3,4,12,13). Standardization of perioperative enhanced recovery protocols is still under progress, as surgical units modify their components.…”

Section: Review Articlementioning

confidence: 99%

Enhanced recovery after surgery (ERAS) programs for esophagectomy

Rubinkiewicz¹,

Witowski²,

Su³

et al. 2019

J. Thorac. Dis

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A perioperative treatment protocol, enhanced recovery after surgery (ERAS) focuses on accelerating patient recovery. Previous studies confirmed that ERAS decreases surgical trauma and the stress response, which improved outcomes including reduced length of hospital stay (LOS) and decreased postoperative morbidity. While ERAS protocols have been successfully implemented in a variety of surgical disciplines (colorectal, bariatric, orthopedic, and gynecologic surgery), its use in esophageal surgery is still limited. This paper analyzes the feasibility and value of the ERAS protocol for esophageal surgery. Reviewing the literature found that implementation of ERAS resulted in decreased costs, length of stay and pulmonary specific complication reduction, but not overall morbidity. The evidence lacks randomized control trials. Further, the ERAS Society published recommendations for esophageal resection. This opportunity for unification of the protocol would make the studies more comparable and leads to stronger conclusions. Surgery specific items also require further confirmation. Nonetheless, the successful introduction of the ERAS protocol into a wide variety of surgical disciplines provides optimism for ERAS's effectiveness in esophageal surgery.

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“…After initial evaluation, 597 studies were removed for being duplicates, 2,204 for being irrelevant (as determined by reading the abstracts), and 67 studies were excluded for reasons determined by reading the full text (Additional File 2). 16 studies [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] were included in the final meta-analysis. Fig.…”

Section: Literature Identificationmentioning

confidence: 99%

The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

Huang

Zhu

Luo

et al. 2019

Preprint

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Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods : Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results : A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection ( RR =0.50, 95%CI: 0.33 to 0.75 ), postoperative length of stay ( MD =-2.53, 95%CI: -3.42 to -1.65 ) , time until first postoperative flatus ( MD =-0.64, 95%CI: -0.84 to -0.45 ) and time until first postoperative defecation ( MD =-1.10, 95%CI: -1.74 to -0.47 ) in patients who received ERAS, compared to conventional care . However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P=0.10), surgical site infection (P=0.42), postoperative anastomotic leakage (P=0.45), readmissions (P=0.31) and ileus (P =0.25). Conclusions : ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

show abstract

Feasibility and outcomes of modified enhanced recovery after surgery for nursing management of aged patients undergoing esophagectomy

Cited by 15 publications

References 19 publications

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

Enhanced recovery after surgery (ERAS) programs for esophagectomy

The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

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