scholarly journals A systematic review of enhanced recovery after surgery for vascular operations

2019 ◽  
Vol 70 (2) ◽  
pp. 629-640.e1 ◽  
Author(s):  
Katharine L. McGinigle ◽  
Jens Eldrup-Jorgensen ◽  
Rebecca McCall ◽  
Nikki L. Freeman ◽  
Luigi Pascarella ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery

Outcomes of Enhanced Recovery After Surgery (ERAS) in Gynecologic Oncology—A Systematic Review and Meta-analysis

2021 ◽  
Vol 76 (4) ◽  
pp. 202-203
Author(s):  
S. P. Bisch ◽  
C. A. Jago ◽  
E. Kalogera ◽  
H. Ganshorn ◽  
L. A. Meyer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Gynecologic Oncology

scholarly journals Staff experiences of enhanced recovery after surgery: systematic review of qualitative studies

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e022259 ◽  
Author(s):  
Rachel Cohen ◽  
Rachael Gooberman-Hill
Keyword(s):  
Systematic Review ◽  
Health Professionals ◽  
Multidisciplinary Team ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Professional Staff ◽  
Qualitative Studies ◽  
Diverse Range ◽  
Qualitative Approaches ◽  
Wide Range

ObjectivesTo conduct a systematic review of qualitative studies which explore health professionals’ experiences of and perspectives on the enhanced recovery after surgery (ERAS) pathway.DesignSystematic review of qualitative literature using a qualitative content analysis. Literature includes the experiences and views of a wide range of multidisciplinary team and allied health professional staff, to incorporate a diverse range of clinical and professional perspectives.Data sourcesPsycINFO, Medline, CINAHL and PubMed were searched in May 2017.Eligibility criteria for selecting studiesThe searches included relevant qualitative studies across a range of healthcare contexts. We included studies published from 2000 to 2017, as an appropriate time frame to capture evidence about ERAS after implementation in the late 1990s. Only studies published in the English language were included, and we included studies that explicitly stated that they used qualitative approaches.Data extraction and synthesisLiterature searches were conducted by the first author and checked by the second author: both contributed to the extraction and analysis of data. Studies identified as relevant were assessed for eligibility using the Critical Appraisal Skills Programme guidance.ResultsEight studies were included in the review, including studies in six countries and in four surgical specialties. Included studies focus on health professionals’ experiences of ERAS before, during and after implementation in colorectal surgery, gastrointestinal surgery, abdominal hysterectomy and orthopaedics. Five main themes emerged in the analysis: communication and collaboration, resistance to change, role and significance of protocol-based care, and knowledge and expectations. Professionals described the importance of effective multidisciplinary team collaboration and communication, providing thorough education to staff and patients, and appointing a dedicated champion as means to implement and integrate ERAS pathways successfully. Evidence-based guidelines were thought to be useful for improvements to patient care by standardising practices and reducing treatment variations, but were thought to be too open to interpretation at local levels. Setting and managing ‘realistic’ expectations of staff was seen as a priority. Staff attitudes towards ERAS tend to become more favourable over time, as practices become successfully ‘normalised’. Strengths of the review are that it includes a wide range of different studies, a variety of clinical populations, diversity of methodological approaches and local contexts. Its limitation is the inclusion of a small number of studies, although these represent six countries and four surgical specialties, and so our findings are likely to be transferable.ConclusionsStaff feel positive about the implementation of ERAS, but find the process is complex and challenging. Challenges can be addressed by ensuring that multidisciplinary teams understand ERAS principles and guidelines, and communicate well with one another and with patients. Provision of comprehensive, coherent and locally relevant information to health professionals is helpful. Identifying and recruiting local ERAS champions is likely to improve the implementation and delivery of ERAS pathways.PROSPERO registration numberCRD42017059952

Enhanced recovery after surgery program for patients undergoing pancreaticoduodenectomy: A systematic review and meta-analysis

Pancreatology ◽  
2015 ◽  
Vol 15 (3) ◽  
pp. S115
Author(s):  
Peter Szatmary ◽  
Junjie Xiong ◽  
Wei Huang ◽  
Chunlu Tan ◽  
Quentin Nunes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis

Enhanced recovery after surgery (ERAS) pathways in breast reconstruction: systematic review and meta-analysis of the literature

2018 ◽  
Vol 173 (1) ◽  
pp. 65-77 ◽  
Author(s):  
Anaeze C. Offodile ◽  
Cindy Gu ◽  
Stefanos Boukovalas ◽  
Christopher J. Coroneos ◽  
Abhishek Chatterjee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Breast Reconstruction ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis

Enhanced Recovery after Surgery in Breast Reconstruction: A Systematic Review

2019 ◽  
Vol 35 (09) ◽  
pp. 695-704 ◽  
Author(s):  
Carol E. Soteropulos ◽  
Sherry Y.Q. Tang ◽  
Samuel O. Poore
Keyword(s):  
Systematic Review ◽  
Length Of Stay ◽  
Breast Reconstruction ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Fluid Management ◽  
Patient Counseling ◽  
Opioid Use ◽  
Full Spectrum ◽  
Alloplastic Breast Reconstruction

Background Enhanced Recovery after Surgery (ERAS) principles have received focused attention in breast reconstruction. Many protocols have been described in the literature for both autologous and alloplastic reconstruction. This systematic review serves to better characterize successful ERAS protocols described in the literature for potential ease of adoption at institutions desiring implementation. Methods A systematic review of ERAS protocols for autologous and alloplastic breast reconstruction was conducted using Medline, the Cochrane Database, and Web of Science. Results Eleven cohort studies evaluating ERAS protocols for autologous (n = 8) and alloplastic (n = 3) breast reconstruction were included for review. The majority compared with a retrospective cohort of traditional perioperative care. All studies described the full spectrum of implemented ERAS protocols including preoperative, intraoperative, and postoperative phases of care. Most frequently reported significant outcomes were reduced length of stay and opioid use with ERAS implementation. No significant change in major complication or readmission rate was demonstrated. Conclusion Based on this systematic review, several core elements that make up a successful perioperative enhanced recovery protocol for breast reconstruction have been identified. Elements include patient counseling and education, limited preoperative fasting, appropriate thromboprophylaxis and antibiotic prophylaxis dependent on reconstructive method, preoperative antiemetics, multimodal analgesia and use of local anesthetic, goal-directed intravenous fluid management, prompt removal of drains and catheters, early diet advancement, and encouragement of ambulation postoperatively. Implementation of ERAS protocols in both autologous and alloplastic breast reconstruction can positively enhance patient experience and improve outcomes by reducing length of stay and opioid use, without compromising successful reconstructive outcomes.

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