دورية أكاديمية
أعرض في EDS

Esophagectomy Enhanced Recovery After Surgery Initiative Results in Improved Outcomes.

التفاصيل البيبلوغرافية
العنوان: Esophagectomy Enhanced Recovery After Surgery Initiative Results in Improved Outcomes.
المؤلفون: Sims CR 3rd; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota., Abou Chaar MK; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Kerfeld MH; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota., Cassivi SD; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Hofer RE; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota., Nichols FC; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Reisenauer J; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Saddoughi SS; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Shen KR; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Stewart TM; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota., Tapias LF; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Wigle DA; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota., Blackmon SH; Division of Thoracic Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: shandablackmon@hotmail.com.
المصدر: The Annals of thoracic surgery [Ann Thorac Surg] 2024 Apr; Vol. 117 (4), pp. 847-857. Date of Electronic Publication: 2023 Dec 02.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 15030100R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6259 (Electronic) Linking ISSN: 00034975 NLM ISO Abbreviation: Ann Thorac Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: Amsterdam : Elsevier
Original Publication: Boston.
مواضيع طبية MeSH: Enhanced Recovery After Surgery* , Esophageal Neoplasms* , Ileus*/complications , Ileus*/surgery, Humans ; Male ; Aged ; Female ; Esophagectomy/methods ; Treatment Outcome ; Postoperative Complications/etiology ; Arrhythmias, Cardiac/complications ; Length of Stay ; Retrospective Studies
مستخلص: Background: Esophagectomy for esophageal cancer is a procedure with high morbidity and mortality. This study developed a Multidisciplinary Esophagectomy Enhanced Recovery Initiative (MERIT) pathway and analyzed implementation outcomes in a single institution.
Methods: The MERIT pathway was developed as a practice optimization and quality improvement initiative. Patients were studied from November 1, 2021 to June 20, 2022 and were compared with historical control subjects. The Wilcoxon rank sum test and the Fisher exact test were used for statistical analysis.
Results: The study compared 238 historical patients (January 17, 2017 to December 30, 2020) with 58 consecutive MERIT patients. There were no significant differences between patient characteristics in the 2 groups. In the MERIT group, 49 (85%) of the patients were male, and their mean age was 65 years (range, 59-71 years). Most cases were performed for esophageal cancer after neoadjuvant therapy. Length of stay improved by 27% from 11 to 8 days (P = .27). There was a 12% (P = .05) atrial arrhythmia rate reduction, as well as a 9% (P = .01) decrease in postoperative ileus. Overall complications were reduced from 54% to 35% (-19%; P = .01).
Conclusions: This study successfully developed and implemented an enhanced recovery after surgery pathway for esophagectomy. In the first year, study investigators were able to reduce overall complications, specifically atrial arrhythmias, and postoperative ileus.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
تواريخ الأحداث: Date Created: 20231203 Date Completed: 20240325 Latest Revision: 20240325
رمز التحديث: 20240325
DOI: 10.1016/j.athoracsur.2023.10.032
PMID: 38043851
قاعدة البيانات: MEDLINE
الوصف
تدمد:1552-6259
DOI:10.1016/j.athoracsur.2023.10.032