Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced Recovery After Surgery (ERAS®) Society Recommendations - Part II: Postoperative management and special considerations.

Details

Serval ID
serval:BIB_5E375934982C
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced Recovery After Surgery (ERAS®) Society Recommendations - Part II: Postoperative management and special considerations.
Journal
European journal of surgical oncology
Author(s)
Hübner M., Kusamura S., Villeneuve L., Al-Niaimi A., Alyami M., Balonov K., Bell J., Bristow R., Guiral D.C., Fagotti A., Falcão LFR, Glehen O., Lambert L., Mack L., Muenster T., Piso P., Pocard M., Rau B., Sgarbura O., Somashekhar S.P., Wadhwa A., Altman A., Fawcett W., Veerapong J., Nelson G.
ISSN
1532-2157 (Electronic)
ISSN-L
0748-7983
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
46
Number
12
Pages
2311-2323
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Enhanced recovery after surgery (ERAS) pathways have been shown to considerably reduce complications, length of stay and costs after most of surgical procedures by standardised application of best evidence-based perioperative care. The aim was to elaborate dedicated recommendations for cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC) in a two-part series of guidelines based on expert consensus. The present part II of the guidelines highlights postoperative management and special considerations.
The core group assembled a multidisciplinary panel of 24 experts involved in peritoneal surface malignancy surgery representing the fields of general surgery (n = 12), gynaecological surgery (n = 6), and anaesthesia (n = 6). Experts systematically reviewed and summarized the available evidence on 72 identified perioperative care items, following the GRADE (grading of recommendations, assessment, development, evaluation) system. Final consensus (defined as ≥50%, or ≥70% of weak/strong recommendations combined) was reached by a standardised 2-round Delphi process, regarding the strength of recommendations.
Response rates were 100% for both Delphi rounds. Quality of evidence was evaluated high, moderate low and very low, for 15 (21%), 26 (36%), 29 (40%) and 2 items, respectively. Consensus was reached for 71/72(98.6%) items. Strong recommendations were defined for 37 items. No consensus could be reached regarding the preemptive use of fresh frozen plasma.
The present ERAS recommendations for CRS ± HIPEC are based on a standardised expert consensus process providing clinicians with valuable guidance. There is an urgent need to produce high quality studies for CRS ± HIPEC and to prospectively evaluate recommendations in clinical practice.
Keywords
Cytoreductive surgery, Enhanced recovery, Guidelines, HIPEC, Perioperative care
Pubmed
Web of science
Open Access
Yes
Create date
15/09/2020 11:09
Last modification date
10/03/2021 7:27
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