Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations.

Détails

Ressource 1Télécharger: 27549599 (4).pdf (552.58 [Ko])
Etat: Serval
Version: Author's accepted manuscript
ID Serval
serval:BIB_D1437E253F41
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Guidelines for Perioperative Care for Liver Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations.
Périodique
World Journal of Surgery
Auteur(s)
Melloul E., Hübner M., Scott M., Snowden C., Prentis J., Dejong C.H., Garden O.J., Farges O., Kokudo N., Vauthey J.N., Clavien P.A., Demartines N.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Statut éditorial
Publié
Date de publication
2016
Peer-reviewed
Oui
Volume
40
Numéro
10
Pages
2425-2440
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
BACKGROUND: Enhanced Recovery After Surgery (ERAS) is a multimodal pathway developed to overcome the deleterious effect of perioperative stress after major surgery. In colorectal surgery, ERAS pathways reduced perioperative morbidity, hospital stay and costs. Similar concept should be applied for liver surgery. This study presents the specific ERAS Society recommendations for liver surgery based on the best available evidence and on expert consensus.
METHODS: A systematic review was performed on ERAS for liver surgery by searching EMBASE and Medline. Five independent reviewers selected relevant articles. Quality of randomized trials was assessed according to the Jadad score and CONSORT statement. The level of evidence for each item was determined using the GRADE system. The Delphi method was used to validate the final recommendations.
RESULTS: A total of 157 full texts were screened. Thirty-seven articles were included in the systematic review, and 16 of the 23 standard ERAS items were studied specifically for liver surgery. Consensus was reached among experts after 3 rounds. Prophylactic nasogastric intubation and prophylactic abdominal drainage should be omitted. The use of postoperative oral laxatives and minimally invasive surgery results in a quicker bowel recovery and shorter hospital stay. Goal-directed fluid therapy with maintenance of a low intraoperative central venous pressure induces faster recovery. Early oral intake and mobilization are recommended. There is no evidence to prefer epidural to other types of analgesia.
CONCLUSIONS: The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/09/2016 17:31
Dernière modification de la notice
09/05/2019 1:35
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