The effect of the introduction of the ERAS protocol in laparoscopic total mesorectal excision for rectal cancer

Huibers, Corlina Johanna Alida; Roos, Marnix A.J. de; Ong, Konrad

doi:10.1007/s00384-011-1385-3

Cited by 44 publications

(31 citation statements)

References 29 publications

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“…The patients should be encouraged to start on the oral intake of clear fluids, and normal diet following surgery [15]. Oral fluid intake was started immediately after (Huibers et [17][18][19][20]. In the present study, peri-and post-operative administrated intravenous fluids were significantly lower in the ERAS group.…”

Section: Discussionmentioning

confidence: 45%

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

2018

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Objectives: In the present study, we aimed to compare the postoperative compliance and complications between ERAS and conventional postoperative care in patients undergoing abdominal hysterectomies. Material and methods:This is the prospective, randomized, controlled trial, which involved 62 patients, who underwent abdominal hysterectomy between December 2016 to February 2017. A total of 30 patients formed the ERAS group. A total of 32 patients who received conventional perioperative care and matched for age, body mass index (BMI) and American Society of Anesthesiologists score were assigned as a control group. Groups were compared in terms of patient characteristics [age, body mass index, ASA Score, parity, diagnosis, type of surgery, and perioperative intravenous fluids], postoperative compliance (postoperative intravenous fluids, time to first flatus, first defecation, ambulation, eating solid food, and postoperative hospital stay), and postoperative complications.Results: Peri-and post-operative administrated intravenous fluids were significantly lower in the ERAS group (p < 0.001 for both). Time to first flatus (p = 0.001), time to first defecation (p < 0.001), and time to eating solid food (p < 0.001) were all significantly shorter in the ERAS group. Post-operative early mobilization on the first postoperative day was achieved in eight (26.7%) patients in the ERAS group. There were no significant differences in complications. One (3.3%) patient in the ERAS Group and 11 (34.4%) patients in the Conventional Group required hospital readmission after discharge (p = 0.002). Conclusion:The ERAS protocol seems to be a simple tool for reducing the incidence of postoperative complications and shortening hospitalization.

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Section: Discussionmentioning

confidence: 45%

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

2018

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“…Notably, the outcome of the study by Huibers et al [25] departed significantly from the normal distribution. Thus, the outcome was not included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 93%

Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis

et al. 2014

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BackgroundBoth laparoscopic and fast-track surgery (FTS) have shown some advantages in colorectal surgery. However, the effectiveness of using both methods together is unclear. We performed this meta-analysis to compare the effects of FTS with those of traditional perioperative care in laparoscopic colorectal cancer surgery.MethodsWe searched the PubMed, EMBASE, Cochrane Library, and Ovid databases for eligible studies until April 2014. The main end points were the duration of the postoperative hospital stay, time to first flatus after surgery, time of first bowel movement, total postoperative complication rate, readmission rate, and mortality.ResultsFive randomized controlled trials and 5 clinical controlled trials with 1,317 patients were eligible for analysis. The duration of the postoperative hospital stay (weighted mean difference [WMD], –1.64 days; 95% confidence interval [CI], –2.25 to –1.03; p < 0.001), time to first flatus (WMD, –0.40 day; 95% CI, –0.77 to –0.04; p = 0.03), time of first bowel movement (WMD, –0.98 day; 95% CI, –1.45 to –0.52; p < 0.001), and total postoperative complication rate (risk ratio [RR], 0.67; 95% CI, 0.56–0.80; p < 0.001) were significantly reduced in the FTS group. No significant differences were noted in the readmission rate (RR, 0.64; 95% CI, 0.41–1.01; p = 0.06) or mortality (RR, 1.55; 95% CI, 0.42–5.71; p = 0.51).ConclusionAmong patients undergoing laparoscopic colorectal cancer surgery, FTS is associated with a significantly shorter postoperative hospital stay, more rapid postoperative recovery, and, notably, greater safety than is expected from traditional care.

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“…Besides cosmetic aspects, similarity in short-term patient-related benefits such as reduction in narcotics and oral analgesics as well as earlier resumption of bowel activity and hospital discharge has been demonstrated in multiple trials [19,20,21,22,23]. More importantly, there were no significant differences in overall disease-free survival and time to recurrence, as well as port or wound site metastases for laparoscopic-assisted techniques [24,25,26,27,28].…”

Section: Current Surgical Treatment Strategies For Colorectal Cancermentioning

confidence: 99%

Surgery for Colorectal Cancer - Trends, Developments, and Future Perspectives

et al. 2016

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Background: Although colorectal surgery is long established as the mainstay treatment for colon cancer, certain topics regarding technical fine-tuning to increase postsurgical recurrence-free survival have remained a matter of debate throughout the past years. These include complete mesocolic excision (CME), treatment strategies for metastatic disease, significance of hyperthermic intraperitoneal chemotherapy (HIPEC), and surgical techniques for the treatment of colorectal cancer recurrence. In addition, new surgical techniques have been introduced in oncologic colorectal surgery, and their potential to provide sufficiently radical resection has yet to be proven. Methods: A structured review of the literature was performed to identify the current state of the art with regard to the mentioned key issues in colorectal surgery. Results: This article provides a comprehensive review of the current literature addressing the above-mentioned current challenges in colorectal surgery. The focus lies on the impact of CME and, in relation to this, on lymph node dissection, as well as on treatment of metastatic disease including peritoneal spread, and finally on the treatment of recurrent disease. Conclusion: Uniformly, the current literature reveals that surgery aiming at complete malignancy elimination within multimodal treatment approaches represents the fundamental quantum leap for the achievement of long-term tumor-free survival.

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The effect of the introduction of the ERAS protocol in laparoscopic total mesorectal excision for rectal cancer

Cited by 44 publications

References 29 publications

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

Enhanced recovery after surgery (ERAS) versus conventional postoperative care in patients undergoing abdominal hysterectomies

Fast-track surgery versus traditional perioperative care in laparoscopic colorectal cancer surgery: a meta-analysis

Surgery for Colorectal Cancer - Trends, Developments, and Future Perspectives

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