Abstract:Our results confirm that introduction of an ERAS protocol for colorectal surgery allows quicker postoperative recovery and shortens the length of stay compared to historical series.
“…No significant differences were found for readmission rates, surgical complications and mortality. This review found several other studies with consistent conclusions in colorectal surgery, reporting that ERAS programs reduce LOSH [36][37][38][39][40][41][42]. Shida et al [43] found these same results in patients operated for obstructed colorectal cancer.…”
Introduction: In recent years, enhanced recovery after surgery protocols have increasingly been integrated into perioperative care of patients undergoing digestive surgery.
“…No significant differences were found for readmission rates, surgical complications and mortality. This review found several other studies with consistent conclusions in colorectal surgery, reporting that ERAS programs reduce LOSH [36][37][38][39][40][41][42]. Shida et al [43] found these same results in patients operated for obstructed colorectal cancer.…”
Introduction: In recent years, enhanced recovery after surgery protocols have increasingly been integrated into perioperative care of patients undergoing digestive surgery.
“…Given that there are no FTS guidelines for gynaecological oncological surgery, we refer to the guidelines for gastrectomy, colorectal surgery, and pancreaticoduodenectomy (Table 2 and Fig. 1) [18â20]. Fig.…”
BackgroundFast-track surgery (FTS), also known as enhanced recovery after surgery, is a multidisciplinary approach to accelerate recovery, reduce complications, minimise hospital stay without increasing readmission rates, and reduce health care costs, all without compromising patient safety. The advantages of FTS in abdominal surgery most likely extend to gynaecological surgery, but this is an assumption, as FTS in elective gynaecological surgery has not been well studied. No consensus guidelines have been developed for gynaecological oncological surgery although surgeons have attempted to introduce slightly modified FTS programmes for patients undergoing such surgery. To our knowledge, there are no published randomised controlled trials; however, some studies have shown that FTS in gynaecological oncological surgery leads to early hospital discharge with high levels of patient satisfaction. The aim of this study is whether FTS reduces the length of stay in hospital compared to traditional management. The secondary aim is whether FTS is associated with any increase in post-surgical complications compared to traditional management (for both open and laparoscopic surgery).Methods/designThis trial will prospectively compare FTS and traditional management protocols. The primary endpoint is the length of post-operative hospitalisation (days, meanâ±âstandard deviation), defined as the number of days between the date of discharge and the date of surgery. The secondary endpoints are complications in both groups (FTS versus traditional protocol) occurring during the first 3 months post-operatively including infection (wound infection, lung infection, intraperitoneal infection), post-operative nausea and vomiting, ileus, post-operative haemorrhage, post-operative thrombosis, and the Acute Physiology and Chronic Health Enquiry II score.DiscussionThe advantages of FTS most likely extend to gynaecology, although, to our knowledge, there are no randomised controlled trials. The aim of this study is to compare the post-operative length of hospitalisation after major gynaecological or gynaecological oncological surgery and to analyse patientsâ post-operative complications. This trial may reveal whether FTS leads to early hospital discharge with few complications after gynaecological surgery.Trial registration number
NCT02687412. Approval Number: SCCHEC20160001. Date of registration: registered on 23 February 2016.
“…Thirteen articles published between 2012 and 2015 met our proposed inclusion criteria 14,17,18â28 . In 2013, four of these articles (30.8%) were published 20,23,24,27 .…”
Section: Purpose and Objectivesmentioning
confidence: 99%
“…In 2013, four of these articles (30.8%) were published 20,23,24,27 . Among the articles we reviewed, the World Journal of Surgery published four studies (30.8%), 17,20,21,24 and the remaining journals published one study each 14,18,19,22,23,25â28 . All studies included were published in English and the primary author was a physician.…”
We undertook an integrative literature review of articles pertaining to perioperative nursing care provided to patients using postoperative accelerated recovery protocols. To select the articles, we searched the MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health Literature, and LiteraturaLatino-Americana e do Caribe em CiĂȘncias da SaĂșde databases. We identified 329 studies, 13 of which met our inclusion criteria and described perioperative nursing care activities. Nursing activities noted in these articles were hypothermia prevention and maintenance of normothermia, restriction of IV fluids, assessment of vital signs, management of symptoms and pain, support of early ambulation, care for tubes and drains, oral administration of carbohydrate-rich foods, assessment of ability to tolerate diet, and encouragement to resume activities of daily living. There was a lack of research on this topic by nursing professionals; additional research by nursing professionals is needed regarding nurses' roles in providing this care.
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