scholarly journals Abandoning Prophylactic Abdominal Drainage after Hepatic Surgery: 10 Years of No-Drain Policy in an Enhanced Recovery after Surgery Environment

2017 ◽  
Vol 34 (5) ◽  
pp. 411-420 ◽  
Author(s):  
Edgar M. Wong-Lun-Hing ◽  
Victor van Woerden ◽  
Toine M. Lodewick ◽  
Marc H.A. Bemelmans ◽  
Steven W.M. Olde Damink ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hepatic Surgery ◽  
Abdominal Drainage

scholarly journals Enhanced Recovery After Surgery in Patients With Hepatocellular Carcinoma Undergoing Laparoscopic Hepatectomy

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiamin Zhou ◽  
Xigan He ◽  
Miao Wang ◽  
Yiming Zhao ◽  
Ning Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Postoperative Morbidity ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Laparoscopic Hepatectomy ◽  
Pringle Maneuver ◽  
Abdominal Drainage ◽  
Free Survival ◽  
Tube Removal ◽  
Alanine Aminotransferase Level

Objective: To compare the effectiveness and safety of enhanced recovery after surgery (ERAS) in patients with hepatocellular carcinoma (HCC) undergoing laparoscopic hepatectomy.Methods: From September 2016 to June 2019, 282 patients were enrolled, and ERAS was implemented since March 2018. All indicators related to surgery, liver function, and postoperative outcomes were included in the analysis. Propensity score matching (PSM) identified 174 patients for further comparison.Results: After PSM, the clinicopathological baselines were well-matched. The group showed significantly less intraoperative blood loss (100.00 [100.00–200.00] vs. 200.00 [100.00–300.00] ml, P = 0.001), fewer days before abdominal drainage tube removal (4.00 [3.00–4.00] days vs. 4.00 [3.00–5.00] days, P = 0.023), shorter hospital stay after surgery (6.00 [5.00–6.00] days vs. 6.00 [6.00–7.00] days, P < 0.001), and reduced postoperative morbidity (18.39 vs. 34.48%, P = 0.026). The proportion of patients with a pain score ≥ 4 was significantly lower in the ERAS group within the first 2 days after surgery (1.15 vs. 13.79% and 8.05 vs. 26.44%, P = 0.002 and P = 0.001, respectively). Pringle maneuver was performed more frequently in the ERAS group (70.11 vs. 18.39%, P < 0.001), and a significantly higher postoperative alanine aminotransferase level was also observed (183.40 [122.85–253.70] vs. 136.20 [82.93–263.40] U/l, P = 0.026). The 2-year recurrence-free survival was similar between the two groups (72 vs. 71%, P = 0.946).Conclusions: ERAS programs are feasible and safe and do not influence mid-term recurrence in HCC patients undergoing laparoscopic hepatectomy.

Is Current Perioperative Practice in Hepatic Surgery Based on Enhanced Recovery After Surgery (ERAS) Principles?

2013 ◽  
Vol 38 (5) ◽  
pp. 1127-1140 ◽  
Author(s):  
E. M. Wong-Lun-Hing ◽  
R. M. van Dam ◽  
L. A. Heijnen ◽  
O. R. C. Busch ◽  
T. Terkivatan ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hepatic Surgery

Psychological influences on wound healing

2019 ◽  
Vol 98 (8) ◽  
pp. 312-314
Keyword(s):  
Wound Healing ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Wound Complications ◽  
State Of Mind ◽  
Life Threatening ◽  
Psychological Influences ◽  
Fear And Anxiety ◽  
Care Costs

Surgical wound complications remain a major cause of morbidity; although usually not life threatening, they reduce the quality of life. They are also associated with excessive health care costs. Wound healing is affected by many factors – wound characteristics, infection, comorbidities and nutritional status of the patient. In addition, though, psychological stress and depression may decrease the inflammatory response required for bacterial clearance and so delay wound healing, as well. Although the patient´s state of mind can be influenced only to a certain extent, we should nevertheless stick to ERAS (Enhanced Recovery After Surgery) guidelines and try to diminish fear and anxiety by providing enough information preoperatively, pay due attention to postoperative analgesia and seek to provide an agreeable environment.

Postoperative Outcomes within Enhanced Recovery after Surgery Protocol in Colorectal Surgery. (Power Study)

2018 ◽  
Author(s):  
Javier Ripollés-Melchor ◽  
José M. Ramírez-Rodríguez ◽  
Rubén Casans-Francés ◽  
César Aldecoa ◽  
Ane Abad-Motos ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Postoperative Outcomes ◽  
Power Study
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