nach oben

Surgery Today

Erschienen in:

01.12.2012 | Original Article

Usefulness of an enhanced recovery after surgery protocol for perioperative management following open repair of an abdominal aortic aneurysm

verfasst von: Wataru Tatsuishi, Takayuki Kohri, Kojiro Kodera, Ryota Asano, Go Kataoka, Sayaka Kubota, Kiyoharu Nakano

Erschienen in: Surgery Today | Ausgabe 12/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To achieve early recovery and early discharge from the hospital by applying an enhanced recovery after surgery (ERAS) protocol, which is mainly used with colonic surgery, for the perioperative management of open AAA surgery.

Method

One hundred twenty-seven open AAA surgery cases successfully carried out between 2003 and 2011 were included in this study. The ERAS protocol was used for the cases from April 2008 onward, and we performed a comparison of the conventionally treated cases with ERAS cases regarding the start of postoperative oral consumption, the postoperative hospital stay, and hospitalization medical costs.

Results

The time to restarting oral consumption and the postoperative hospital stay were significantly shorter for the ERAS group (n = 52) compared to the conventionally managed group (n = 75); with values of 59 ± 15 and 93 ± 25 h (p = 0.021), 9 ± 3 and 16 ± 5 days (p = 0.001), respectively. The medical costs for the ERAS group were 92 % of the costs of the conventionally managed group.

Conclusion

Use of the ERAS protocol for the perioperative management of open AAA surgery shortened the time before recommencing oral consumption, the postoperative hospital stay, and reduced the medical costs compared to the conventional approach.

Fearon KC, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CH, Lassen K, et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr. 2005;24:466–77.PubMedCrossRef

Eskicioglu C, Forbes SS, Aarts MA, Okrainec A, McLeod RS. Enhanced recovery after surgery (ERAS) programs for patients having colorectal surgery: a meta-analysis of randomized trials. J Gastrointest Surg. 2009;13:2321–9.PubMedCrossRef

Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C, Enhanced Recovery After Surgery (ERAS) Group, et al. Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations. Arch Surg. 2009;144:961–9.PubMedCrossRef

Abraham N, Albayati S. Enhanced recovery after surgery programs hasten recovery after colorectal resections. World J Gastrointest Surg. 2011;3:1–6.PubMedCrossRef

Maeda H, Umezawa H, Goshima M, Hattori T, Nakamura T, Umeda T, et al. Primary infected abdominal aortic aneurysm: surgical procedures, early mortality rates, and a survey of the prevalence of infectious organisms over a 30-year period. Surg Today. 2011;41(3):346–51.PubMedCrossRef

O’Brien G, Buckley K, Vanwalleghem G, Vanrenterghem D, Dharma H, Winter RL, et al. A multi-centre, prospective, clinical in-market evaluation to assess the performance of OPSITE™ Post-Op Visible dressings. Int Wound J. 2010;7:329–37.PubMedCrossRef

Cotton P. Fast-track improves CABG outcomes. JAMA. 1993;270:2023.PubMedCrossRef

Kehlet H, Dahl JB. Anesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003;362:1921–8.PubMedCrossRef

Wilmore DW, Kehlet H. Management of patients in fast track surgery. BMJ. 2001;322:473–6.PubMedCrossRef

10.

Kehlet H, Mongensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation program. Br J Surg. 1999;86:227–30.PubMedCrossRef

11.

Podore PC, Throop EB. Infrarenal aortic surgery with a 3-day hospital stay: a report on success with a clinical pathway. J Vasc Surg. 1999;29:787–92.PubMedCrossRef

12.

White PF, Kehelt H, Neal JM, Schricker T, Carr DB, Fast-Track Surgery Study Group. The role of the anesthesiologist in fast-track surgery: from multimodal analgesia to perioperative medical care. Anesth Analg. 2007;104:1380–96.PubMedCrossRef

13.

Gouvas N, Tan E, Wingsor A, Xynos E, Tekkis PP. Fast-track vs standard care in colorectal surgery: a meta-analysis update. Int J Colorectal Dis. 2009;24:1119–31.PubMedCrossRef

14.

Norris EJ, Beattie C, Perler BA, Martinez EA, Meinert CL, Anderson GF, et al. Double-masked randomized trial comparing alternate combinations of intraoperative anesthesia and postoperative analgesia in abdominal aortic surgery. Anesthesiology. 2001;95:1054–67.PubMedCrossRef

15.

Liu SS, Carpenter RL, Mackey DC, Thirlby RC, Rupp SM, Shine TS, et al. Effects of perioperative analgesic technique on rate of recovery after colon surgery. Anesthesiology. 1995;83:757–65.PubMedCrossRef

16.

Mochiki E, Yanai M, Ohno T, Kuwano H. The effect of traditional Japanese medicine (Kampo) on gastrointestinal function. Surg Today. 2010;40:1105–11.PubMedCrossRef

Titel: Usefulness of an enhanced recovery after surgery protocol for perioperative management following open repair of an abdominal aortic aneurysm
verfasst von: Wataru Tatsuishi
Takayuki Kohri
Kojiro Kodera
Ryota Asano
Go Kataoka
Sayaka Kubota
Kiyoharu Nakano
Publikationsdatum: 01.12.2012
Verlag: Springer Japan
Erschienen in: Surgery Today / Ausgabe 12/2012
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-012-0252-3

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Usefulness of an enhanced recovery after surgery protocol for perioperative management following open repair of an abdominal aortic aneurysm