Read by QxMD icon Read


shared collection
60 papers 500 to 1000 followers Enhanced recovery after surgery
By Christian Zalai Colorectal surgeon based in Montreal
Sarah E Deery, Paul M Cavallaro, Sean T McWalters, Syrene R Reilly, Holly M Bonnette, David W Rattner, Elizabeth A Mort, David C Hooper, Marcela G Del Carmen, Liliana G Bordeianou
MINI: We began a quality improvement project distributing free Surgical Site Infection Prevention Kits (SSIPK) to all patients undergoing elective colectomy. Patients who received the kit, compared to propensity matched controls who did not receive the kit, had fewer postoperative surgical site infections, lower rates of postoperative ileus, shorter hospital lengths of stay, and fewer readmissions. INTRODUCTION: Patient compliance with preoperative mechanical and antibiotic bowel preparation, skin washes, carbohydrate loading, and avoidance of fasting are key components of successful colorectal ERAS and surgical site infection (SSI)-reduction programs...
January 24, 2019: Annals of Surgery
Robert D Becher, Terrence E Murphy, Evelyne A Gahbauer, Linda Leo-Summers, Hans F Stabenau, Thomas M Gill
MINI: The potential predictors of functional recovery after major surgery in geriatric patients have not been well-studied. This prospective longitudinal study evaluated recovery of premorbid function within 6 months of major surgery, and identified factors associated with functional recovery among older persons who survive a major surgery with increased disability. OBJECTIVE: The objectives of the current study were 2-fold: first, to evaluate the incidence and time to recovery of premorbid function within 6 months of major surgery and second, to identify factors associated with functional recovery among older persons who survive a major surgery with increased disability...
February 6, 2019: Annals of Surgery
U O Gustafsson, M J Scott, M Hubner, J Nygren, N Demartines, N Francis, T A Rockall, T M Young-Fadok, A G Hill, M Soop, H D de Boer, R D Urman, G J Chang, A Fichera, H Kessler, F Grass, E E Whang, W J Fawcett, F Carli, D N Lobo, K E Rollins, A Balfour, G Baldini, B Riedel, O Ljungqvist
BACKGROUND: This is the fourth updated Enhanced Recovery After Surgery (ERAS® ) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol. METHODS: A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system...
November 13, 2018: World Journal of Surgery
Nicolò Pecorelli, Julio F Fiore, Pepa Kaneva, Abarna Somasundram, Patrick Charlebois, A Sender Liberman, Barry L Stein, Franco Carli, Liane S Feldman
INTRODUCTION: While patient engagement and clinical audit are key components of successful enhanced recovery programs (ERPs), they require substantial resource allocation. The objective of this study was to assess the validity and usability of a novel mobile device application for education and self-reporting of adherence for patients undergoing bowel surgery within an established ERP. METHODS: Prospectively recruited patients undergoing bowel surgery within an ERP used a novel app specifically designed to provide daily recovery milestones and record adherence to 15 different ERP processes and six patient-reported outcomes (PROs)...
May 2018: Surgical Endoscopy
Alexander B. Stone, Christina T. Yuan, Michael A. Rosen, Michael C. Grant, Lauren E. Benishek, Elizabeth Hanahan, Lisa H. Lubomski, Clifford Ko, Elizabeth C. Wick
No abstract text is available yet for this article.
March 1, 2018: JAMA Surgery
Julia R Berian, Kristen A Ban, Jason B Liu, Christine L Sullivan, Clifford Y Ko, Julie K M Thacker, Liane S Feldman
Importance: Enhanced recovery protocols (ERPs) are standardized care plans of best practices that can decrease morbidity and length of stay (LOS). However, many hospitals need help with implementation. The Enhanced Recovery in National Surgical Quality Improvement Program (ERIN) pilot was designed to support ERP implementation. Objective: To evaluate the association of the ERIN pilot with LOS after colectomy. Design, Setting, and Participants: Using a difference-in-differences design, pilot LOS before and after ERP implementation was compared with matched controls in a hierarchical model, adjusting for case mix and random effects of hospitals and matched pairs...
April 1, 2018: JAMA Surgery
Allison N Martin, Puja Shah Berry, Charles M Friel, Traci L Hedrick
BACKGROUND: Minimally invasive surgery (MIS) for rectal cancer has increased in recent years. Enhanced recovery (ER) protocols are associated with improved outcomes, such as decreased length of stay (LOS). We examined the impact of MIS and ER protocols on outcomes after rectal resection for neoplasm. METHODS: A retrospective analysis was performed for patients undergoing elective open (OS) or MIS rectal resection for neoplasm from 2010 to 2015 at a single institution...
May 2018: Surgical Endoscopy
Michael W Manning, William Jonathan Dunkman, Timothy E Miller
Goal-directed fluid therapy (GDFT) seeks to improve outcomes through individualized optimization of oxygen delivery using IV fluid and vasoactive infusions. Trials of GDFT show clinical benefits over traditional liberal fluid administration, but fail to demonstrate benefits when compared to a restrictive strategy within an optimized enhanced recovery protocol. The ideal monitors, hemodynamic goals, and fluid administration strategy are not well established but may be less important than rational application of thoughtful fluid management strategies...
October 2017: Journal of Surgical Oncology
Trevor Wood, Mary-Anne Aarts, Allan Okrainec, Emily Pearsall, J Charles Victor, Marg McKenzie, Ori Rotstein, Robin S McLeod
BACKGROUND: Enhanced Recovery After Surgery (ERAS) guidelines have been widely promoted and supported largely due to several studies showing decreased post-operative complications and length of stay. The objective of this study was to review the emergency room (ER) visits and readmission rates and reasons for both in patients who were part of the Implementation of an Enhanced Recovery After Surgery (iERAS) program for colorectal surgery. METHODS: All patients having elective colorectal surgery at 15 academic hospitals were enrolled in the iERAS program...
February 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Keaton Jones, Alex Gordon-Weeks, Claire Coleman, Michael Silva
BACKGROUND: Individualised risk prediction is crucial if targeted pre-operative risk reduction strategies are to be deployed effectively. Radiologically determined sarcopenia has been shown to predict outcomes across a range of intra-abdominal pathologies. Access to pre-operative cross-sectional imaging has resulted in a number of studies investigating the predictive value of radiologically assessed sarcopenia over recent years. This systematic review and meta-analysis aimed to determine whether radiologically determined sarcopenia predicts post-operative morbidity and mortality following abdominal surgery...
September 2017: World Journal of Surgery
Julio Flavio Fiore, Tanya Castelino, Nicolò Pecorelli, Petru Niculiseanu, Saba Balvardi, Olivia Hershorn, Sender Liberman, Patrick Charlebois, Barry Stein, Franco Carli, Nancy E Mayo, Liane S Feldman
OBJECTIVE: To estimate the extent to which the addition of staff-directed facilitation of early mobilization to an Enhanced Recovery Program (ERP) impacts recovery after colorectal surgery, compared with usual care. SUMMARY BACKGROUND DATA: Early mobilization is considered an important component of ERPs but, despite guidelines recommendations, adherence remains quite low. The value of dedicating specific resources (eg, staff time) to increase early mobilization is unknown...
August 2017: Annals of Surgery
A C Currie, G Malietzis, J T Jenkins, T Yamada, H Ashrafian, T Athanasiou, K Okabayashi, R H Kennedy
BACKGROUND: Laparoscopic approaches and standardized recovery protocols have reduced morbidity following colorectal cancer surgery. As the optimal regimen remains inconclusive, a network meta-analysis was undertaken of treatments for the development of postoperative complications and mortality. METHODS: MEDLINE, Embase, trial registries and related reviews were searched for randomized trials comparing laparoscopic and open surgery within protocol-driven or conventional perioperative care for colorectal cancer resection, with complications as a defined endpoint...
December 2016: British Journal of Surgery
Baddr A Shakhsheer, Luke A Versten, James N Luo, Jennifer R Defazio, Robin Klabbers, Scott Christley, Alexander Zaborin, Kristina L Guyton, Monika Krezalek, Daniel P Smith, Nadim J Ajami, Joseph F Petrosino, Irma D Fleming, Natalia Belogortseva, Olga Zaborina, John C Alverdy
BACKGROUND: Despite ever more powerful antibiotics, newer surgical techniques, and enhanced recovery programs, anastomotic leaks remain a clear and present danger to patients. Previous work from our laboratory suggests that anastomotic leakage may be caused by Enterococcus faecalis strains that express a high collagenase phenotype (i.e., collagenolytic). Yet the mechanisms by which the practice of surgery shifts or selects for collagenolytic phenotypes to colonize anastomotic tissues remain unknown...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Michael J Englesbe, Alisha D Lussiez, Jeffrey F Friedman, June A Sullivan, Stewart C Wang
No abstract text is available yet for this article.
December 2015: Annals of Surgery
Zhobin Moghadamyeghaneh, Grace Hwang, Mark H Hanna, Michael J Phelan, Joseph C Carmichael, Steven D Mills, Alessio Pigazzi, Matthew O Dolich, Michael J Stamos
BACKGROUND: A small decrease in the serum albumin from the normal level is a common condition in preoperative laboratory tests of colorectal surgery patients; however, there is limited data examining these patients. We sought to identify outcomes of such patients. METHODS: The National Surgical Quality Improvement Program database was used to evaluate all patients who had modest levels of hypoalbuminemia (3 ≤ serum albumin < 3.5 g/dL) before colorectal resection from 2005 to 2012...
August 2015: American Journal of Surgery
(no author information available yet)
BACKGROUND: The ERAS (enhanced recovery after surgery) care has been shown in randomized clinical trials to improve outcome after colorectal surgery compared to traditional care. The impact of different levels of compliance and specific elements, particularly out with a trial setting, is poorly understood. OBJECTIVE: This study evaluated the individual impact of specific patient factors and perioperative enhanced recovery protocol compliance on postoperative outcome after elective primary colorectal cancer resection...
June 2015: Annals of Surgery
S Huddart, C J Peden, M Swart, B McCormick, M Dickinson, M A Mohammed, N Quiney
BACKGROUND: Emergency laparotomies in the U.K., U.S.A. and Denmark are known to have a high risk of death, with accompanying evidence of suboptimal care. The emergency laparotomy pathway quality improvement care (ELPQuiC) bundle is an evidence-based care bundle for patients undergoing emergency laparotomy, consisting of: initial assessment with early warning scores, early antibiotics, interval between decision and operation less than 6 h, goal-directed fluid therapy and postoperative intensive care...
January 2015: British Journal of Surgery
Tung T Tran, Pepa Kaneva, Nancy E Mayo, Gerald M Fried, Liane S Feldman
BACKGROUND: Although duration of hospital stay commonly is used as a surrogate outcome for surgical recovery, it is not applicable in the setting of short-stay surgery (<24 hours). The objective of our study was to describe the trajectory of recovery after short-stay abdominal surgery by using measures of physical activity and health-related quality of life (HRQL) and identify predictors of prolonged, postdischarge recovery. METHODS: Patients undergoing short-stay abdominal surgery were evaluated preoperatively and at 3 weeks and 2 months postoperatively...
July 2014: Surgery
Wael Khreiss, Marianne Huebner, Robert R Cima, Eric R Dozois, Heidi K Chua, John H Pemberton, William S Harmsen, David W Larson
BACKGROUND: Enhanced recovery pathways have been shown to decrease the length of hospital stay in patients undergoing colorectal surgery. Few reports have studied patients undergoing minimally invasive surgery for rectal cancer. OBJECTIVE: Our aim was to review our experience in minimally invasive rectal cancer surgery. We report short-term outcomes and evaluate the potential advantages of the enhanced recovery protocol compared with our less intensive conventional pathway...
May 2014: Diseases of the Colon and Rectum
Brian H Cuthbertson, Marion K Campbell, Stephen A Stott, Andrew Elders, Rodolfo Hernández, Dwayne Boyers, John Norrie, John Kinsella, Julie Brittenden, Jonathan Cook, Daniela Rae, Seonaidh C Cotton, David Alcorn, Jennifer Addison, Adrian Grant
INTRODUCTION: Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. METHODS: This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery...
2011: Critical Care: the Official Journal of the Critical Care Forum
2014-04-18 13:39:56
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"