Postoperative Outcomes within Enhanced Recovery after Surgery Protocol in Colorectal Surgery. (Power Study)

Ripollés‐Melchor, Javier; Ramírez-Rodríguez, José M.; Casans‐Francés, Rubén; Aldecoa, César; Abad‐Motos, Ane; Logroño-Egea, Margarita; García‐Erce, José Antonio; Camps-Cervantes, Ángels; Ferrando-Ortolá, Carlos; Suárez-de-la-Rica, Alejandro; Cuellar-Martínez, Ana; Marmaña-Mezquita, Sandra; Abad‐Gurumeta, Alfredo; Calvo-Vecino, J.M.

doi:10.2139/ssrn.3212330

Cited by 2 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a recent study from our group, 16 we were able to verify that despite having undergone training and having established an ERAS protocol in colorectal surgery, it was not fully implemented in daily clinical practice, with certain elements of the protocol having very low compliance, even in specialised centres. In this same study, which involved 2084 patients from 80 centres in our country, we found that an increase in compliance with evidence-based recommendations that constitute the PRI is associated with a decrease in postoperative complications.…”

Section: Introductionmentioning

confidence: 91%

“…According to the Postoperative Outcomes Within Enhanced Recovery After Surgery Protocol in Colorectal Surgery study that includes data from 82 Spanish hospitals, 16 only 60% of centres with an ERAS protocol achieve more than 70% compliance. As such, we consider a scenario of seven high-compliance (HC) and five low-compliance (LC) centres among the 12 hospitals that will collaborate with this research project.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical treatment for colorectal cancer: analysis of the influence of an enhanced recovery programme on long-term oncological outcomes—a study protocol for a prospective, multicentre, observational cohort study

et al. 2020

Self Cite

View full text Add to dashboard Cite

IntroductionThe evidence currently available from enhanced recovery after surgery (ERAS) programmes concerns their benefits in the immediate postoperative period, but there is still very little evidence as to whether their correct implementation benefits patients in the long term. The working hypothesis here is that, due to the lower response to surgical aggression and lower rates of postoperative complications, ERAS protocols can reduce colorectal cancer-related mortality. The main objective of this study is to analyse the impact of an ERAS programme for colorectal cancer on 5-year survival. As secondary objectives, we propose to analyse the weight of each of the predefined items in the oncological results as well as the quality of life.Methods and analysisA multicentre prospective cohort study was conducted in patients older than 18 years of age who are scheduled to undergo surgery for colorectal cancer. The study involved 12 hospitals with an implemented enhanced recovery protocol according to the guidelines published by the Spanish National Health Service. The intervention group includes patients with a minimum implementation level of 70%, and the control group includes those who fail to reach this level. Compliance will be studied using 18 key performance indicators, and the results will be analysed using cancer survival indicators, including overall survival, cancer-specific survival and relapse-free survival. The time to recurrence, perioperative morbidity and mortality, hospital stay and quality of life will also be studied, the latter using the validated EuroQol Five questionnaire. The propensity index method will be used to create comparable treatment and control groups, and a multivariate regression will be used to study each variable. The Kaplan-Meier estimator will be used to estimate survival and the log-rank test to make comparisons. A p value of less than 0.05 (two-tailed) will be considered to be significant.Ethics and disseminationEthical approval for this study was obtained from the Aragon Ethical Committee (C.P.-C.I. PI20/086) on 4 March 2020. The findings of this study will be submitted to peer-reviewed journals (BMJ Open, JAMA Surgery, Annals of Surgery, British Journal of Surgery). Abstracts will be submitted to relevant national and international meetings.Trial registration numberNCT04305314.

show abstract

Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Surgical treatment for colorectal cancer: analysis of the influence of an enhanced recovery programme on long-term oncological outcomes—a study protocol for a prospective, multicentre, observational cohort study

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…El estudio POWER mostró que los pacientes con mayor adherencia a ERAS presentaron una disminución en la tasa de complicaciones moderadas a severas (OR, 0.34; IC 95%, 0.25-0.46; P <. 001), sobre todas las complicaciones (OR, 0,33; IC del 95%, 0,26-0,43; P < 0,001), en comparación con los pacientes con una menor adherencia 3 .…”

Section: Grupo Español De Rehabilitación Multimodal (Germ)unclassified

“…Además de los factores de riesgo mencionados anteriormente, los factores de riesgo bien conocidos que deben tenerse en cuenta para la IRA incluyen el aumento de la edad, los antecedentes de diabetes y el índice de riesgo cardíaco 22 , y están surgiendo nuevos factores de riesgo como la evidencia de proteinuria preoperatoria 23 . Entre los ítems ERAS relacionados con IRA, resulta evidente que es complejo encontrar evidencia firme en estudios observacionales, puesto que la literatura nos demuestra que la adherencia a ERAS es baja 3,24 , por lo tanto, es plausible pensar que la adherencia a determinadas intervenciones como la THGO sea baja. POWER mostró que la THGO no se asociaba con mejores resultados, sin embargo, si un balance postoperatorio restrictivo.…”

Section: Grupo Español De Rehabilitación Multimodal (Germ)unclassified

Insuficiencia renal aguda postoperatoria en cirugía colorrectal y entorno eras: una llamada de atención

Melchor¹

2020

Arch. coloproctol.

View full text Add to dashboard Cite

La clave para la adopción inicial de los protocolos de recuperación mejorada después de la cirugía (ERAS) fue la evidencia temprana de que la disminución de la duración de la estancia y los costos hospitalarios asociados con los protocolos ERAS no estaban asociados con el aumento de las tasas de readmisión o la tasa general de complicaciones. Sin embargo, existe controversia y discrepancia en resultados; principalmente debido a que, como ya se apuntó hace una década, simplemente tener un protocolo no mejorará los resultados postoperatorios. Una alta adherencia a los protocolos ERAS en cirugía colorrectal ha demostrado que mejora los resultados postoperatorios. El estudio POWER mostró que los pacientes con mayor adherencia a ERAS presentaron una disminución en la tasa de complicaciones moderadas a severas (OR, 0.34; IC 95%, 0.25-0.46; P <. 001), sobre todas las complicaciones (OR, 0,33; IC del 95%, 0,26-0,43; P < 0,001), en comparación con los pacientes con una menor adherencia.

show abstract

Postoperative Outcomes within Enhanced Recovery after Surgery Protocol in Colorectal Surgery. (Power Study)

Cited by 2 publications

References 0 publications

Surgical treatment for colorectal cancer: analysis of the influence of an enhanced recovery programme on long-term oncological outcomes—a study protocol for a prospective, multicentre, observational cohort study

Surgical treatment for colorectal cancer: analysis of the influence of an enhanced recovery programme on long-term oncological outcomes—a study protocol for a prospective, multicentre, observational cohort study

Insuficiencia renal aguda postoperatoria en cirugía colorrectal y entorno eras: una llamada de atención

Contact Info

Product

Resources

About