An enhanced recovery pathway decreases duration of stay after esophagectomy
Purpose Enhanced recovery pathways (ERP) decrease morbidity and duration of stay after colorectal surgery. There is little information about their role in complex procedures, such as esophagectomy. The purpose of this study was to determine the impact of an ERP on duration of stay, complications, an...
Gespeichert in:
| Veröffentlicht in: | Surgery 2012-10, Vol.152 (4), p.606-616 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 616 |
|---|---|
| container_issue | 4 |
| container_start_page | 606 |
| container_title | Surgery |
| container_volume | 152 |
| creator | Li, Chao, MD Ferri, Lorenzo E., MD, PhD Mulder, David S., MD Ncuti, Annie, BSc Neville, Amy, MD Lee, Lawrence, MD Kaneva, Pepa, MSc Watson, Debbie, RN Vassiliou, Melina, MD Carli, Franco, MD, MPhil Feldman, Liane S., MD, FRCSC, FACS |
| description | Purpose Enhanced recovery pathways (ERP) decrease morbidity and duration of stay after colorectal surgery. There is little information about their role in complex procedures, such as esophagectomy. The purpose of this study was to determine the impact of an ERP on duration of stay, complications, and readmissions after esophagectomy. Methods Patients undergoing esophagectomy for cancer or high-grade dysplasia from June 2009 to December 2011 were identified from a prospectively maintained database. Beginning in June 2010, all patients were enrolled in a 7-day multidisciplinary ERP including written patient education with daily treatment plan, indications for intensive care admission, early structured mobilization, and diet and drain management. Short-term (30-day) outcomes were compared for patients undergoing esophagectomy pre- and post-pathway. Data are expressed as median values [interquartile range]. Results We identified 106 patients; 47 underwent esophagectomy before ERP implementation and 59 after. Patients were similar with respect to age, gender, diagnosis, and operative time. Hospital stay was shorter in the ERP group (8 [7–17] vs 10 [9–17] days; P = .01). There were no differences in rates of complications (59% vs 62%) or readmissions (6% vs 5%). Conclusion Implementation of a multidisciplinary ERP for esophagectomy was associated with decreased duration of stay, without an increase in complications or readmissions. |
| doi_str_mv | 10.1016/j.surg.2012.07.021 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1081874945</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0039606012003728</els_id><sourcerecordid>1081874945</sourcerecordid><originalsourceid>FETCH-LOGICAL-c507t-32521094fd7ea861032dfcfe05b001ab3acc9c0fb85074d4a5a9371d9b21864d3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi0EokvhD3BAuSD1kjD-iJNICKmq-BKVOLScLcced71k48VOWuXf42gXkDj0NJbmecejZwh5TaGiQOW7XZXmeFcxoKyCpgJGn5ANrTkrGy7pU7IB4F0pQcIZeZHSDgA6Qdvn5IyxTvBWiA35djkWOG71aNAWEU24x7gUBz1tH_RSWDQRdcJU2DnqyYexCK5IU25pN2EsMIXDVt-hmcJ-eUmeOT0kfHWq5-THp4-3V1_K6--fv15dXpemhmYqOasZzZs426BuJQXOrDMOoe4BqO65NqYz4Po248IKXeuON9R2PaOtFJafk4vj3EMMv2ZMk9r7ZHAY9IhhTopCS9tGdKLOKDuiJoaUIjp1iH6v45IhtUpUO7VKVKtEBY3KEnPozWn-3O_R_o38sZaBtydAJ6MHF7M-n_5xUkjeSZa590cOs417j1El43FV7bPqSdngH9_jw39xM_jR5x9_4oJpF-Y4Zs-KqpQz6mY993ptyvKrYS3_DRl_pNE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1081874945</pqid></control><display><type>article</type><title>An enhanced recovery pathway decreases duration of stay after esophagectomy</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Li, Chao, MD ; Ferri, Lorenzo E., MD, PhD ; Mulder, David S., MD ; Ncuti, Annie, BSc ; Neville, Amy, MD ; Lee, Lawrence, MD ; Kaneva, Pepa, MSc ; Watson, Debbie, RN ; Vassiliou, Melina, MD ; Carli, Franco, MD, MPhil ; Feldman, Liane S., MD, FRCSC, FACS</creator><creatorcontrib>Li, Chao, MD ; Ferri, Lorenzo E., MD, PhD ; Mulder, David S., MD ; Ncuti, Annie, BSc ; Neville, Amy, MD ; Lee, Lawrence, MD ; Kaneva, Pepa, MSc ; Watson, Debbie, RN ; Vassiliou, Melina, MD ; Carli, Franco, MD, MPhil ; Feldman, Liane S., MD, FRCSC, FACS</creatorcontrib><description>Purpose Enhanced recovery pathways (ERP) decrease morbidity and duration of stay after colorectal surgery. There is little information about their role in complex procedures, such as esophagectomy. The purpose of this study was to determine the impact of an ERP on duration of stay, complications, and readmissions after esophagectomy. Methods Patients undergoing esophagectomy for cancer or high-grade dysplasia from June 2009 to December 2011 were identified from a prospectively maintained database. Beginning in June 2010, all patients were enrolled in a 7-day multidisciplinary ERP including written patient education with daily treatment plan, indications for intensive care admission, early structured mobilization, and diet and drain management. Short-term (30-day) outcomes were compared for patients undergoing esophagectomy pre- and post-pathway. Data are expressed as median values [interquartile range]. Results We identified 106 patients; 47 underwent esophagectomy before ERP implementation and 59 after. Patients were similar with respect to age, gender, diagnosis, and operative time. Hospital stay was shorter in the ERP group (8 [7–17] vs 10 [9–17] days; P = .01). There were no differences in rates of complications (59% vs 62%) or readmissions (6% vs 5%). Conclusion Implementation of a multidisciplinary ERP for esophagectomy was associated with decreased duration of stay, without an increase in complications or readmissions.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2012.07.021</identifier><identifier>PMID: 22943844</identifier><identifier>CODEN: SURGAZ</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Aged ; Biological and medical sciences ; Esophageal Diseases - surgery ; Esophageal Neoplasms - surgery ; Esophagectomy - adverse effects ; Esophagectomy - methods ; Esophagus ; Female ; General aspects ; Humans ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Patient Education as Topic ; Patient Readmission ; Perioperative Care ; Postoperative Complications - prevention & control ; Prospective Studies ; Stomach, duodenum, intestine, rectum, anus ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Treatment Outcome</subject><ispartof>Surgery, 2012-10, Vol.152 (4), p.606-616</ispartof><rights>Mosby, Inc.</rights><rights>2012 Mosby, Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-32521094fd7ea861032dfcfe05b001ab3acc9c0fb85074d4a5a9371d9b21864d3</citedby><cites>FETCH-LOGICAL-c507t-32521094fd7ea861032dfcfe05b001ab3acc9c0fb85074d4a5a9371d9b21864d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.surg.2012.07.021$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26463962$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22943844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Li, Chao, MD</creatorcontrib><creatorcontrib>Ferri, Lorenzo E., MD, PhD</creatorcontrib><creatorcontrib>Mulder, David S., MD</creatorcontrib><creatorcontrib>Ncuti, Annie, BSc</creatorcontrib><creatorcontrib>Neville, Amy, MD</creatorcontrib><creatorcontrib>Lee, Lawrence, MD</creatorcontrib><creatorcontrib>Kaneva, Pepa, MSc</creatorcontrib><creatorcontrib>Watson, Debbie, RN</creatorcontrib><creatorcontrib>Vassiliou, Melina, MD</creatorcontrib><creatorcontrib>Carli, Franco, MD, MPhil</creatorcontrib><creatorcontrib>Feldman, Liane S., MD, FRCSC, FACS</creatorcontrib><title>An enhanced recovery pathway decreases duration of stay after esophagectomy</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Purpose Enhanced recovery pathways (ERP) decrease morbidity and duration of stay after colorectal surgery. There is little information about their role in complex procedures, such as esophagectomy. The purpose of this study was to determine the impact of an ERP on duration of stay, complications, and readmissions after esophagectomy. Methods Patients undergoing esophagectomy for cancer or high-grade dysplasia from June 2009 to December 2011 were identified from a prospectively maintained database. Beginning in June 2010, all patients were enrolled in a 7-day multidisciplinary ERP including written patient education with daily treatment plan, indications for intensive care admission, early structured mobilization, and diet and drain management. Short-term (30-day) outcomes were compared for patients undergoing esophagectomy pre- and post-pathway. Data are expressed as median values [interquartile range]. Results We identified 106 patients; 47 underwent esophagectomy before ERP implementation and 59 after. Patients were similar with respect to age, gender, diagnosis, and operative time. Hospital stay was shorter in the ERP group (8 [7–17] vs 10 [9–17] days; P = .01). There were no differences in rates of complications (59% vs 62%) or readmissions (6% vs 5%). Conclusion Implementation of a multidisciplinary ERP for esophagectomy was associated with decreased duration of stay, without an increase in complications or readmissions.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Esophageal Diseases - surgery</subject><subject>Esophageal Neoplasms - surgery</subject><subject>Esophagectomy - adverse effects</subject><subject>Esophagectomy - methods</subject><subject>Esophagus</subject><subject>Female</subject><subject>General aspects</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Patient Education as Topic</subject><subject>Patient Readmission</subject><subject>Perioperative Care</subject><subject>Postoperative Complications - prevention & control</subject><subject>Prospective Studies</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Treatment Outcome</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EokvhD3BAuSD1kjD-iJNICKmq-BKVOLScLcced71k48VOWuXf42gXkDj0NJbmecejZwh5TaGiQOW7XZXmeFcxoKyCpgJGn5ANrTkrGy7pU7IB4F0pQcIZeZHSDgA6Qdvn5IyxTvBWiA35djkWOG71aNAWEU24x7gUBz1tH_RSWDQRdcJU2DnqyYexCK5IU25pN2EsMIXDVt-hmcJ-eUmeOT0kfHWq5-THp4-3V1_K6--fv15dXpemhmYqOasZzZs426BuJQXOrDMOoe4BqO65NqYz4Po248IKXeuON9R2PaOtFJafk4vj3EMMv2ZMk9r7ZHAY9IhhTopCS9tGdKLOKDuiJoaUIjp1iH6v45IhtUpUO7VKVKtEBY3KEnPozWn-3O_R_o38sZaBtydAJ6MHF7M-n_5xUkjeSZa590cOs417j1El43FV7bPqSdngH9_jw39xM_jR5x9_4oJpF-Y4Zs-KqpQz6mY993ptyvKrYS3_DRl_pNE</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Li, Chao, MD</creator><creator>Ferri, Lorenzo E., MD, PhD</creator><creator>Mulder, David S., MD</creator><creator>Ncuti, Annie, BSc</creator><creator>Neville, Amy, MD</creator><creator>Lee, Lawrence, MD</creator><creator>Kaneva, Pepa, MSc</creator><creator>Watson, Debbie, RN</creator><creator>Vassiliou, Melina, MD</creator><creator>Carli, Franco, MD, MPhil</creator><creator>Feldman, Liane S., MD, FRCSC, FACS</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20121001</creationdate><title>An enhanced recovery pathway decreases duration of stay after esophagectomy</title><author>Li, Chao, MD ; Ferri, Lorenzo E., MD, PhD ; Mulder, David S., MD ; Ncuti, Annie, BSc ; Neville, Amy, MD ; Lee, Lawrence, MD ; Kaneva, Pepa, MSc ; Watson, Debbie, RN ; Vassiliou, Melina, MD ; Carli, Franco, MD, MPhil ; Feldman, Liane S., MD, FRCSC, FACS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c507t-32521094fd7ea861032dfcfe05b001ab3acc9c0fb85074d4a5a9371d9b21864d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Esophageal Diseases - surgery</topic><topic>Esophageal Neoplasms - surgery</topic><topic>Esophagectomy - adverse effects</topic><topic>Esophagectomy - methods</topic><topic>Esophagus</topic><topic>Female</topic><topic>General aspects</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Patient Education as Topic</topic><topic>Patient Readmission</topic><topic>Perioperative Care</topic><topic>Postoperative Complications - prevention & control</topic><topic>Prospective Studies</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Chao, MD</creatorcontrib><creatorcontrib>Ferri, Lorenzo E., MD, PhD</creatorcontrib><creatorcontrib>Mulder, David S., MD</creatorcontrib><creatorcontrib>Ncuti, Annie, BSc</creatorcontrib><creatorcontrib>Neville, Amy, MD</creatorcontrib><creatorcontrib>Lee, Lawrence, MD</creatorcontrib><creatorcontrib>Kaneva, Pepa, MSc</creatorcontrib><creatorcontrib>Watson, Debbie, RN</creatorcontrib><creatorcontrib>Vassiliou, Melina, MD</creatorcontrib><creatorcontrib>Carli, Franco, MD, MPhil</creatorcontrib><creatorcontrib>Feldman, Liane S., MD, FRCSC, FACS</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Chao, MD</au><au>Ferri, Lorenzo E., MD, PhD</au><au>Mulder, David S., MD</au><au>Ncuti, Annie, BSc</au><au>Neville, Amy, MD</au><au>Lee, Lawrence, MD</au><au>Kaneva, Pepa, MSc</au><au>Watson, Debbie, RN</au><au>Vassiliou, Melina, MD</au><au>Carli, Franco, MD, MPhil</au><au>Feldman, Liane S., MD, FRCSC, FACS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>An enhanced recovery pathway decreases duration of stay after esophagectomy</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2012-10-01</date><risdate>2012</risdate><volume>152</volume><issue>4</issue><spage>606</spage><epage>616</epage><pages>606-616</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><coden>SURGAZ</coden><abstract>Purpose Enhanced recovery pathways (ERP) decrease morbidity and duration of stay after colorectal surgery. There is little information about their role in complex procedures, such as esophagectomy. The purpose of this study was to determine the impact of an ERP on duration of stay, complications, and readmissions after esophagectomy. Methods Patients undergoing esophagectomy for cancer or high-grade dysplasia from June 2009 to December 2011 were identified from a prospectively maintained database. Beginning in June 2010, all patients were enrolled in a 7-day multidisciplinary ERP including written patient education with daily treatment plan, indications for intensive care admission, early structured mobilization, and diet and drain management. Short-term (30-day) outcomes were compared for patients undergoing esophagectomy pre- and post-pathway. Data are expressed as median values [interquartile range]. Results We identified 106 patients; 47 underwent esophagectomy before ERP implementation and 59 after. Patients were similar with respect to age, gender, diagnosis, and operative time. Hospital stay was shorter in the ERP group (8 [7–17] vs 10 [9–17] days; P = .01). There were no differences in rates of complications (59% vs 62%) or readmissions (6% vs 5%). Conclusion Implementation of a multidisciplinary ERP for esophagectomy was associated with decreased duration of stay, without an increase in complications or readmissions.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>22943844</pmid><doi>10.1016/j.surg.2012.07.021</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0039-6060 |
| ispartof | Surgery, 2012-10, Vol.152 (4), p.606-616 |
| issn | 0039-6060 1532-7361 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1081874945 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aged Biological and medical sciences Esophageal Diseases - surgery Esophageal Neoplasms - surgery Esophagectomy - adverse effects Esophagectomy - methods Esophagus Female General aspects Humans Length of Stay Male Medical sciences Middle Aged Patient Education as Topic Patient Readmission Perioperative Care Postoperative Complications - prevention & control Prospective Studies Stomach, duodenum, intestine, rectum, anus Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Treatment Outcome |
| title | An enhanced recovery pathway decreases duration of stay after esophagectomy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-15T17%3A13%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=An%20enhanced%20recovery%20pathway%20decreases%20duration%20of%20stay%20after%20esophagectomy&rft.jtitle=Surgery&rft.au=Li,%20Chao,%20MD&rft.date=2012-10-01&rft.volume=152&rft.issue=4&rft.spage=606&rft.epage=616&rft.pages=606-616&rft.issn=0039-6060&rft.eissn=1532-7361&rft.coden=SURGAZ&rft_id=info:doi/10.1016/j.surg.2012.07.021&rft_dat=%3Cproquest_cross%3E1081874945%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1081874945&rft_id=info:pmid/22943844&rft_els_id=1_s2_0_S0039606012003728&rfr_iscdi=true |