Orthostatic intolerance in enhanced recovery laparoscopic colorectal resection

2018 ◽  
Vol 63 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Jens R. Eriksen ◽  
Pia Munk-Madsen ◽  
Henrik Kehlet ◽  
Ismail Gögenur
Keyword(s):  
Colorectal Resection ◽  
Orthostatic Intolerance ◽  
Enhanced Recovery ◽  
Laparoscopic Colorectal Resection

scholarly journals Effects of preoperative oral carbohydrate electrolyte drinks on preoperative hypokalemia incidence in patients scheduled for laparoscopic colorectal resection: a randomized clinical trial

2020 ◽  
Author(s):  
Fang Tan ◽  
Yingqing Deng ◽  
Jingping Hu ◽  
Chulian Gong ◽  
Qianqian Zhu ◽  
...  
Keyword(s):  
Colorectal Resection ◽  
Primary Outcome ◽  
Enhanced Recovery ◽  
Final Analysis ◽  
Well Being ◽  
Control Group ◽  
Case Group ◽  
Laparoscopic Colorectal Resection ◽  
Potassium Supplementation ◽  
Present Trial

Abstract Background:In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients. Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications. Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE. Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital.

scholarly journals Preoperative Immunonutrition vs. Standard Dietary Advice in Normo-Nourished Patients Undergoing Fast-Track Laparoscopic Colorectal Surgery

2021 ◽  
Vol 10 (3) ◽  
pp. 413
Author(s):  
Manfredi Tesauro ◽  
Andrea M. Guida ◽  
Leandro Siragusa ◽  
Bruno Sensi ◽  
Vittoria Bellato ◽  
...  
Keyword(s):  
Colorectal Resection ◽  
Enhanced Recovery ◽  
Gastrointestinal Surgery ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Secondary Outcome ◽  
Dietary Advice ◽  
Laparoscopic Colorectal Resection ◽  
Colorectal Cancer Resection ◽  
Group B

Immunonutrition (IN) appears to reduce infective complications and in-hospital length of stay (LOS) after major gastrointestinal surgery, but its use in normo-nourished patients is still controversial. The primary aim of this comparative observational study was to evaluate if pre-operative IN reduces in-hospital stay in patients undergoing laparoscopic colorectal resection for cancer under an enhanced recovery after surgery (ERAS) program. The influence of IN on time to first bowel movements, time to full oral diet tolerance, number and type of complications, reasons of prolonged LOS and readmission rate was evaluated as secondary outcome. Patients undergoing ERAS laparoscopic colorectal resection between December 2016 and December 2019 were reviewed. Patients who have received preoperative IN (group A) were compared to those receiving standard dietary advice (group B). Mean in-hospital LOS was significantly shorter in patients receiving preoperative IN than standard dietary advice (4.85 ± 2.25 days vs. 6.06 ± 3.95 days; p < 0.0492). No differences in secondary outcomes were observed. Preoperative IN associated with ERAS protocol in normo-nourished patients undergoing laparoscopic colorectal cancer resection seems to reduce LOS.

scholarly journals Effects of Preoperative Oral Carbohydrate Electrolyte Drinks on Preoperative Hypokalemia Incidence in Patients Scheduled for Laparoscopic Colorectal Resection: A Randomized Clinical Trial

2020 ◽  
Author(s):  
Fang Tan ◽  
Yingqing Deng ◽  
Jingping Hu ◽  
Chulian Gong ◽  
Qianqian Zhu ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Colorectal Resection ◽  
Enhanced Recovery ◽  
Final Analysis ◽  
Well Being ◽  
Control Group ◽  
Case Group ◽  
Clinical Trial Registry ◽  
Laparoscopic Colorectal Resection ◽  
Present Trial

Abstract Background: In our previous study, hypokalemia incidence was high in patients scheduled for laparoscopic colorectal resection. The present trial was conducted to verify the effects of preoperative carbohydrate drinks containing potassium in these patients.Methods: Patients were randomly assigned to control, placebo, and case groups. In control group, patients were fasted from midnight. In placebo group, patients were fasted from midnight and received carbohydrate drinks 2–3 h before surgery. In case group, patients were fasted from midnight and received carbohydrate drinks containing potassium supplementation 2–3 h before surgery. The primary outcome was the incidence and severity of preoperative hypokalemia. The other outcomes included postoperative gastrointestinal function, including the time to postoperative first flatus (FFL) and first feces (FFE) and other complications. Results: The final analysis included 122 participants. The incidence of preoperative hypokalemia in case group was significantly lower than that in control and placebo groups (50% vs. 88.1% vs. 77.5%, p < 0.001). The severity of hypokalemia in control and placebo groups was greater than that in case group. No regurgitation or aspiration occurred in the three groups. No significant differences were observed among the three groups regarding time to FFL and FFE. Conclusions: Preoperative carbohydrate drinks containing potassium may have significantly reduced the incidence of preoperative hypokalemia and improved preoperative thirst and hunger, but did not improve postoperative well-being. However, as part of the enhanced recovery after surgery protocol, preoperative carbohydrate drinks containing potassium should be recommended, as early as first admittance to hospital. Trial registration: The study was registered with the Chinese Clinical Trial Registry at www.chictr.org on February 7, 2017 (registration number: ChiCTR-IOR-17010561).

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