Abstract:
BACKGROUND:The aim of this trial was to compare the Enhanced Recovery After Surgery (ERAS) program with conventional perioperative management in patients who underwent radical resection for colorectal cancer. METHODS:A combination of evidence-based and consensus methodology was used to develop the ERAS protocol. Five hundred ninety-seven consecutive patients who underwent elective colorectal resection were randomized to either the ERAS (n = 299) or the control group (n = 298). Outcomes relating to nutrition and metabolism index, stress index, and recovery index were measured and recorded. RESULTS:Demographic and operative data were similar between the two groups. Patients in the ERAS group showed improved nutritional status when compared with those of the control group. On postoperative day (POD) 1, the HOMA-IR (insulin resistance index) of the ERAS group was lower than that of the control group (p < 0.001). The cortisol level of the control group was elevated on both POD 1 (p = 0.007) and POD 5 (p = 0.002) compared to the preoperative level. However, the cortisol level of the ERAS group was not increased until POD 5 (p = 0.001). Reduced levels of TNF-α, IL-1β, IL-6, and IFN-γ in the ERAS group indicated less postoperative stress responses. In addition, ERAS was associated with accelerated recovery of gastrointestinal function. The postoperative length of stay (p < 0.001) and expense (p < 0.001) for the ERAS group were reduced in comparison to the controls. Twenty-eight cases in the control group and twenty-nine in the ERAS group suffered complications, which was not significantly different. CONCLUSION:The ERAS protocol attenuates the surgical stress response and accelerates postoperative recovery without compromising patient safety.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Ren L,Zhu D,Wei Y,Pan X,Liang L,Xu J,Zhong Y,Xue Z,Jin L,Zhan S,Niu W,Qin X,Wu Z,Wu Zdoi
10.1007/s00268-011-1348-4subject
Has Abstractpub_date
2012-02-01 00:00:00pages
407-14issue
2eissn
0364-2313issn
1432-2323journal_volume
36pub_type
杂志文章,随机对照试验abstract::The purpose of this study was to evaluate the surgical outcome of completion thyroidectomy in patients with presumed unilateral well-differentiated thyroid cancer (WDTC). The medical records of all patients having had unilateral thyroid lobectomy for WDTC, who subsequently underwent completion thyroidectomy, were revi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02067365
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:The role of circular staplers in gastroduodenostomy during subtotal gastrectomy for gastric cancer has not been defined clearly. METHODS:A randomized clinical trial included patients with gastric cancer who underwent subtotal gastrectomy with either stapled (99 patients) or handsewn gastroduodenostomy (98 p...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-011-1038-2
更新日期:2011-05-01 00:00:00
abstract::Radiation-induced proctitis with hemorrhage is not a common complication of radiotherapy to the pelvis for carcinoma. In the most severe forms, massive hemorrhage may necessitate repeated transfusions and inpatient treatment. In severe cases medical treatment has not been proved effective. Surgery may lead to serious ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900166
更新日期:1996-10-01 00:00:00
abstract:BACKGROUND:Africa's health workforce crisis has recently been emphasized by major international organizations. As a part of this discussion, it has become apparent that the workforce required to deliver surgical services has been significantly neglected. METHODS:This paper reviews some of the reasons for this relative...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9473-4
更新日期:2008-06-01 00:00:00
abstract:INTRODUCTION:Large incisional hernias with loss of domain (LIHLD) of the abdominal wall remain a therapeutic challenge due to the difficulty of replacing the contents of the hernia sac into the peritoneal cavity. Preoperative progressive pneumoperitoneum (PPP) is a valuable option. The purpose of this study was to eval...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3206-2
更新日期:2015-12-01 00:00:00
abstract::The post-Soviet calamities of East European cardiac surgery highlight the spectrum of marked differences in overall operative capacities among individual post-Communist countries. A comparison with the level of cardiac surgery in Western Europe reveals the importance of continuing relief, comprising both educational a...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-7103-8
更新日期:2003-08-01 00:00:00
abstract::Different types of vagotomy have been widely used in the treatment of peptic ulcer disease. A close relationship between the vagus nerve and the release or action of gastrointestinal hormones is necessary for the optimal activation of the gastrointestinal tract. The serum concentrations of the antral hormone gastrin a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01654771
更新日期:1979-09-20 00:00:00
abstract:BACKGROUND:Surgical resection remains the treatment of choice for carotid body tumors (CBTs). Although perioperative complications such as carotid artery injury and neurological deficits occur infrequently, they can be devastating. The aim of this study was to evaluate whether clinical factors or preoperative imaging f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3058-9
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Schistosomiasis is a waterborne trematode with numerous subtypes affecting different areas of the body. Rob Ferreira Hospital is located in an endemic area for schistosomiasis in the Lowveld region of South Africa. We set out to determine the prevalence of Sch istosoma in appendicitis. METHODS:From 2009 to ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2954-3
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:A small remnant liver volume is an important risk factor for posthepatectomy liver failure and can be predicted accurately by computed tomography (CT) volumetry using radiologic image analysis software. Unfortunately, this software is expensive and usually requires support by a radiologist. ImageJ is a freel...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9197-x
更新日期:2007-11-01 00:00:00
abstract::The authors' affiliations are updated as reflected here. ...
journal_title:World journal of surgery
pub_type: 杂志文章,已发布勘误
doi:10.1007/s00268-020-05519-w
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Differentiated thyroid cancer (DTC) with distant metastases at presentation is uncommon; the prognosis of patients with this condition is more favorable than for other cancers. Demographic, clinical, and pathologic characteristics are described at a population level; factors associated with long-term disease...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2006-9
更新日期:2013-07-01 00:00:00
abstract::The aim of this study was to investigate the effects of various surgical modalities directed at the cavity of hydatid cysts in patients with occult intrabiliary rupture. In this respect, 324 patients with hydatid cyst of the liver operated on during 1983-2003 were analyzed; among them, 39 patients with occult intrabil...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7571-5
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Intraoperative identification of the difficult-to-spot parathyroid gland is critical during surgery for thyroid and parathyroid disease. Recently, intrinsic fluorescence of the parathyroid gland was identified, and a new method was developed for intraoperative detection of the parathyroid with an original fl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3903-0
更新日期:2017-06-01 00:00:00
abstract::Local recurrence in differentiated and medullary thyroid carcinoma develops frequently from metastatic infiltration of cervical lymph nodes. Despite an aggressive surgical approach, postoperative calcitonin levels as biochemical evidence for residual cancer cells remain often elevated in patients with medullary thyroi...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0197-y
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:The open abdomen (OA) is commonly utilized as a technique during damage control laparotomy (DCL). We propose that a selected group of these OA patients can be extubated prior to abdominal closure to decrease ventilator days and risk of pneumonia. METHODS:A retrospective chart review was performed at a Level...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4610-1
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Thyroid cancer (TC) incidence has been increasing in recent years. The aim of this study was to investigate our institution-based estimates of operative volumes for TC over the last three decades. MATERIALS AND METHODS:This was a retrospective cohort study of patients undergoing thyroid surgery at our ins...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3322-z
更新日期:2016-03-01 00:00:00
abstract::The acid-base balance from the postoperative day (POD) 1 to POD 3 after cirrhotic liver resection was investigated in relation to operative outcome by conducting a retrospective study on the changes in arterial ketone body ratio (AKBR), which reflects the hepatic mitochondrial redox state, and arterial blood gas analy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01655722
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Total thyroidectomy is a well-established surgical approach for the management of papillary thyroid cancer (PTC). However, the best surgical approach for papillary microcarcinoma is nowadays still debated. Both total thyroidectomy and simple lobectomy are used. We report the experience of a single University...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3327-7
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Gallbladder (GB) cancer may be discovered incidentally by histopathologic examination following simple cholecystectomy. Incidental GB cancer > or =T2 or > or =N1 needs a second radical resection. It is a matter of concern whether the prognosis may be worse in patients with T2GB cancer who undergo a second ra...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0522-4
更新日期:2010-07-01 00:00:00
abstract::The role of nitric oxide in mediating smooth muscle relaxation is well established. Less is known about the downstream signaling events inside the smooth muscle cell that produce relaxation of the contractile machinery. One possible effector molecule is the small heat shock protein HSP20. Increased phosphorylation of ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-002-4052-6
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Although laparoscopic appendectomy (LA) is widely performed in many countries, LA for complicated appendicitis, which includes perforated or gangrenous appendicitis with or without localized or disseminated peritonitis, has not become a common practice yet. METHODS:We retrospectively analyzed the clinical r...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9843-y
更新日期:2009-02-01 00:00:00
abstract::Technetium 99m ((99m)Tc)-methoxyisobutylisonitrile (MIBI) scintigraphy has been reported to be a useful method for visualizing the parathyroid glands for the diagnosis of hyperparathyroidism. Some drug metabolism transporters, such as p-glycoprotein (P-GP) or multidrug resistance-associated protein (MRP), are believed...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0177-2
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Pancreatic cancer has higher concentrations of angiotensin II compared with other cancers. This study sought to assess the effect of angiotensin II receptor blockers (ARBs) on survival of patients undergoing resection using a large, nationally representative dataset. METHODS:Patients undergoing pancreatic c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4021-8
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:To evaluate whether the preoperative magnetic resonance angiography (MRA) can predict the risk of cerebral ischemia associated with the carotid endarterectomy (CEA). METHODS:Between January 2004 and December 2010, 382 consecutive patients (mean age: 56.6 years; range: 45-78 years) were identified to have un...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1851-2
更新日期:2013-03-01 00:00:00
abstract::Extracorporeal life support has evolved considerably over the past two decades. Once considered as salvage or experimental therapy in adults, extracorporeal membrane oxygenation (ECMO) is evolving into a mainstream treatment for adult critical care. This is especially true in trauma and high-risk surgical patients, wh...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-016-3586-y
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:Advanced Trauma Life Support (ATLS®) is one of the world's best-known training programs for medical providers. Revisions of the ATLS manual have been evidence based for a number of years. In 2011, a level 3 (S3) evidence- and consensus-based guideline on the treatment of patients with severe and multiple injuri...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3063-z
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:The goal of the present study was to determine the frequency, mode of presentation, and need for reoperation in the treatment of recurrent inguinal hernia at Liaquat University Hospital, Jamshoro, Sindh, Pakistan. METHODS:This descriptive, cross-sectional study was conducted over a period of four years, fro...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1897-1
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Few studies have focused on the risk factors for failure to achieve fascial closure after use of negative-pressure wound therapy (NPWT) in an open abdomen (OA). We aimed at analyzing possible risk factors for failure of fascial closure and the risk of fistulas after nontrauma lower gastrointestinal (GI) trac...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-2360-7
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:A majority of patients with end-stage renal disease suffer from secondary hyperparathyroidism, which is associated with osteoporosis and cardiovascular disease. Parathyroidectomy (PTX) is often necessary despite medical treatment. However, the effect of PTX on cardio- and cerebrovascular events (CVE) remains...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05020-z
更新日期:2019-08-01 00:00:00