“Ultra” E.R.A.S. in laparoscopic colectomy for cancer: discharge after the first flatus? A prospective, randomized trial

Garulli, Gianluca; Lucchi, Andrea; Berti, Pierluigi; Gabbianelli, Carlo; Siani, Luca Maria

doi:10.1007/s00464-016-5177-2

Cited by 12 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observe a signi cant reduction of LOS after TKA and a slight increase after THA and no modi cation in the other surgical models. The mean LOS in 2017 in our survey for TKA, colectomy and hysterectomy is much longer than the LOS reported presently in the literature (respectively 4 days for TKA and 2 days for colectomy) and underlines mainly the important room for improvement still existing in our institution (9,10). Interestingly in all individual data collected in our survey in 2015 and 2017, a signi cant correlation exists between the number of ERP items applied and LOS.…”

Section: Los and Postoperative Complicationssupporting

confidence: 39%

Evolution of enhanced recovery program in French university hospitals: a before-after retrospective survey

Harkouk¹,

Capmas²,

Derridj³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Enhanced recovery program (ERP) after surgery needs development in Assistance Publique Hôpitaux de Paris.Methods: a retrospective before-and-after study was performed in 2015 and 2017 on three surgical models (total knee arthroplasty (TKA), colectomy, and hysterectomy) in 17 hospitals including 29 surgical departments. For each elective surgery, data were collected in one control intervention (Total hip arthroplasty (THA), gastrectomy and ovariectomy).To favour development of ERP strategy, in 2016, institutional mobilization developed with one day meeting of information, development of a Massive Open Online Course on ERP, diffusion of national update on ERP by Haute Autorité de Santé and inclusion in a regional professional partnership program. Primary outcomes were length of stay (LOS) and complications after surgery. Data on ERP items were collected in the patients’ chart and in anaesthetist and surgeon interview. 70 % application rate reflects application of ERP procedure.Results: 1321 patient’s files were analysed (812 in 2015 and 509 in 2017). The length of stay (LOS, mean (SD)) is reduced by 1.6 day for TKA (2015: 8.7 (6.7) versus 7.1 (3.4) in 2017; p<0.001) but increases of 0.5 day for THA (2015: 8.2 (4.1) versus 8.7 (15.5) in 2017; p=0.011). LOS is stable for colectomy and hysterectomy as in their control groups (i.e. gastrectomy and ovariectomy). Incidence of severe complications after surgery is unchanged in all type of surgical models except in THA patients (11.1% in 2015 and 1.5% in 2017, p=0.029). For TKA and hysterectomy respectively applied items of ERP (i.e: >70% application) increased respectively from 5 to 7 out of 17 and 16 in 2015 and 2017. For colectomy, they were stable at 6 out of 21 in 2015 and 2017. All centres progressed in ERP between 2015 and 2017 for TKA (7/7 centres) and hysterectomy (6/6 centres). The LOS was negatively correlated with ERP items application when data collected in 2015 and 2017 were analyzed together.Conclusion: ERP application improved between 2015 and 2017 for three surgical models after an institutional information and diffusion of recommendations in 29 surgical departments of seventeen French University hospitals

show abstract

Section: Los and Postoperative Complicationssupporting

confidence: 39%

Evolution of enhanced recovery program in French university hospitals: a before-after retrospective survey

Harkouk¹,

Capmas²,

Derridj³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Further research, in the form of prospective, multi-center, randomized controlled trials, is needed to validate the advantage of SILA within the ERAS protocol. 3 Suppurative appendicitis 4 Perforated appendicitis 5 Gangrenous appendicitis 6 Periappendiceal abscess…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

“…The enhanced recovery after surgery (ERAS) program has been widely adopted in laparoscopic colorectal surgery, as it reduces the risk of perioperative complications [1,2]. The elements of an ERAS protocol are based on the reduction of surgical stress [3]. Several studies demonstrated laparoscopic appendectomy for nonperforated appendicitis to be safely performed as fast-track protocols for children [4][5][6] and adults [7].…”

Section: Introductionmentioning

confidence: 99%

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

et al. 2021

View full text Add to dashboard Cite

The objective of this study was to compare the perioperative outcomes between single incision laparoscopic appendectomy (SILA) and three port appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol. Methods: Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution's ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). Results: After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2±0.8 vs. 1.6±0.8 days, p =0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, p =0.1) and the postoperative visual analogue scores for pain at 6 hours (2.4±1.9 vs. 2.8±1.4, p = 0.260) and 12 hours (2.4±2.0 vs. 2.9±1.5, p=0.257) did not show significant difference between the two groups. Conclusion: SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

show abstract

“…Of 481 manuscripts screened, 37 individual ERPs were published in 37 studies including 41 centres as shown in Figure S1. There were 18 cohort studies, [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] seven historically controlled studies, [33][34][35][36][37][38][39] five guidelines, [40][41][42][43][44] four randomized controlled trials (RCTs), [45][46][47][48] one RCT protocol, 49 one case series 50 and one narrative review. 51 Institutions in Europe were the most frequent study locations (25 of 37, 67.6%), followed by North America (10 of 37, 27%), Asia (4 of 37, 10.8%) and Oceania (2 of 37, 5.4%), respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

Systematic scoping review of enhanced recovery protocol recommendations targeting return of gastrointestinal function after colorectal surgery

Dudi-Venkata

Kroon

Bedrikovetski

et al. 2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background Post‐operative ileus (POI) and delayed return of gastrointestinal (GI) function are common complications after colorectal surgery. There is a lack of uniformity in enhanced recovery protocols (ERPs) with regards to interventions used to target these complications. This systematic review aims to categorize and summarize management recommendations available from published ERPs. Methods A systematic search of Ovid MEDLINE, Embase, Cochrane Library and PubMed databases was performed from January 1990 to May 2018. All studies publishing enhanced recovery or fast‐track or multimodal pathway protocols for colorectal surgery in their full‐text were included. Data on interventions aimed at reducing the duration of POI were extracted, as well as references quoted to support specific interventions. Results Of 481 manuscripts screened, 37 published ERPs were identified from 37 studies (18 cohort, seven historical‐control, five guidelines, four randomized controlled trials, one randomized controlled trial protocol, one case series and one narrative review). The most commonly recommended interventions were magnesium‐based laxatives (18 of 37, 48.6%), chewing gum (13 of 37, 35.1%), Alvimopan (6 of 37, 16.2%), lactulose (4 of 37, 10.8%), neostigmine (2 of 37, 5.4%) and bisacodyl (2 of 37, 5.4%). Geographical trends were noted for the various interventions, but high‐quality evidence was only referenced to support the use of Alvimopan. Conclusion ERP recommendations specific to interventions targeting POI and return of GI function are varied. While laxatives are the most commonly recommended intervention, there is only weak evidence reported to support this practice.

show abstract

“Ultra” E.R.A.S. in laparoscopic colectomy for cancer: discharge after the first flatus? A prospective, randomized trial

Abstract: "Ultra" E.R.A.S. showed to be safe, actual and effective; discharge on postoperative day 2 after the first flatus passage, in the absence of complication-related symptoms, should be actively considered in a modern, multidisciplinary, multimodal laparoscopic management of colonic cancer.

Cited by 12 publications

References 27 publications

Evolution of enhanced recovery program in French university hospitals: a before-after retrospective survey

Evolution of enhanced recovery program in French university hospitals: a before-after retrospective survey

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

Systematic scoping review of enhanced recovery protocol recommendations targeting return of gastrointestinal function after colorectal surgery

Contact Info

Product

Resources

About