Abstract：
:Enhanced recovery after surgery (ERAS) is a multimodal protocol applied towards perioperative patient care. ERAS programs are implemented by a multidisciplinary team centered around the patient, incorporating outpatient clinical staff, preoperative nurses, anesthesiologists, operative nurses, postoperative recovery staff, floor inpatient nurses, dieticians, physical therapists, social workers, and surgeons. Initial studies on perioperative care measures focused on cardiac surgery. Subsequently, the development of the ERAS Study Group in 2001 focused on colorectal surgery and postoperative outcome measures. Today, ERAS protocols have been implemented across many surgical subspecialties including: bariatric, breast, plastic, cardiac, colorectal, esophageal, head and neck, hepatic, gynecologic, neurosurgical, orthopedic, pancreatic, thoracic, and urologic surgery. The goal of ERAS programs is to promote rapid recovery as quantified by decreasing the length of hospital stay, complications, and cost of specific surgical interventions. In the setting of the opioid crisis in America, there is also an increasing focus on minimizing perioperative narcotic use. The purpose of this review is to compare ERAS protocols across surgical subspecialties, focusing on quantified metrics of improvement, and to provide a clear and concise summary of the literature in regards to current ERAS practices and success rates.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Smith TW Jr,Wang X,Singer MA,Godellas CV,Vaince FTdoi
10.1016/j.amjsurg.2019.11.009subject
Has Abstractpub_date
2020-03-01 00:00:00pages
530-534issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(19)31027-Xjournal_volume
219pub_type
杂志文章,评审abstract：BACKGROUND:The standard paradigm for acutely injured patients involves evaluation in an emergency department (ED). Our center has employed a policy for bypassing the ED and proceeding directly to the operating room (OR) based on prehospital criteria. METHODS:This is a retrospective analysis of all trauma patients admi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.001
更新日期：2012-08-01 00:00:00
abstract：:An animal wound model was used to compare the effectiveness of topical and systemic antibiotics and to examine the validity of using a combined regimen of both routes of antibiotic delivery. Gross infection rates and wound bacterial concentrations were determined after contamination with Staphylococcus aureus or Esche...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)91103-p
更新日期：1991-04-01 00:00:00
abstract：BACKGROUND:The underutilization of radiation therapy after breast-conserving surgery in early-stage breast cancer patients has been attributed to the inconvenience and potential side effects of whole-breast radiation treatment regimens. Accelerated partial-breast irradiation (APBI) involves twice-daily treatments more ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.06.024
更新日期：2016-07-01 00:00:00
abstract：:Operative liver biopsy findings were reviewed in 164 consecutive, unselected patients with alcoholic cirrhosis who had bleeding from esophageal varices and underwent emergency portacaval shunt. The survival rate up to 10 years in 49 patients with acute alcoholic hepatitis and alcoholic cirrhosis was not significantly ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90038-2
更新日期：1984-01-01 00:00:00
abstract：:1. Approximately 40,000 cases of cancer of the head and neck (excluding skin) are diagnosed each year. 2. Approximately 20,000 of these cases and 30,000 cases of skin cancer are treated by 366 head and neck cancer surgeons. 3. Ninety per cent of the cases are treated by 63 per cent of the surgeons. 4. Fifty-eight per ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90239-1
更新日期：1975-03-01 00:00:00
abstract：BACKGROUND:This analysis was performed in order to determine whether primary tumor location in breast cancer affects the axillary sentinel lymph node (SLN) identification (ID) rate, the false negative (FN) rate, incidence of axillary nodal metastases, or the number of SLN identified. METHODS:In this prospective multi-...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/s0002-9610(01)00717-6
更新日期：2001-10-01 00:00:00
abstract：:This study prospectively compared the following tests for their accuracy in amputation level selection: transcutaneous oxygen, transcutaneous carbon dioxide, transcutaneous oxygen-to-transcutaneous carbon dioxide, foot-to-chest transcutaneous oxygen, intradermal xenon-133, ankle-brachial index, and absolute popliteal ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90174-7
更新日期：1987-08-01 00:00:00
abstract：BACKGROUND:Venous thromboembolism is the most common preventable cause of hospital death. The objective of this study was to clarify risk factors for postoperative bleeding related to thromboprophylaxis after laparoscopic colorectal cancer surgery. METHODS:The study was conducted at 23 Japanese institutions and includ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2015.10.019
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Little is known about care coordination and communication with outpatient endocrine surgery patients. This study evaluated phone calls between office nurses and surgical patients to identify common issues addressed and their effect on patient care. METHODS:Qualitative analysis of preoperative and postoperat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS:Seven surgery residents were provided structur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.028
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:The changing environment in academic medical centers has had a major effect on the recruitment and the demographic characteristics of leadership positions in academic surgery. Categorization of "cultures" from the business model has been extrapolated into the academic surgical model. METHODS:The types of cu...
journal_title：American journal of surgery
pub_type： 历史文章,杂志文章
doi：10.1016/s0002-9610(02)00814-0
更新日期：2002-04-01 00:00:00
abstract：BACKGROUND:Bloodstream infections in critically ill patients are associated with mortality as high as 60% and a prolonged hospital stay. We evaluated the impact of inappropriate antibiotic therapy (IAAT) in a critically ill surgical cohort with bacteremia. METHODS:This retrospective study evaluated adults with intensi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.10.025
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:This report describes estimated 4-year tumor bed and ipsilateral breast recurrence-free intervals, event-free survival, disease-specific survival, and overall survival in a cohort of MammoSite brachytherapy (MBT) patients with mature follow-up treated at a single institution over a 6-year period. METHODS AN...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.03.005
更新日期：2010-02-01 00:00:00
abstract：:When dense hemiparesis has developed appropriate to the operated vessel after carotid surgery, the patient has been immediately returned to the operating room for reexploration of the vessel and thrombectomy. Over a 5-year period, we identified four patients who developed dense hemiparesis in the recovery room postope...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81262-0
更新日期：1990-05-01 00:00:00
abstract：:Forty-six infants and children with primary malignant liver tumors were studied. Thirty-three had hepatoblastomas, 9 hepatocellular carcinomas, and 4 had sarcomas. Thirty-eight patients underwent liver biopsy or excision of the tumor. Nineteen patients were treated between 1952 and 1971 (mean survival 5.5 months) and ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90381-1
更新日期：1983-08-01 00:00:00
abstract：:The results of the present study emphasize the importance of minimizing the time delay between a significant elevation in CEA and a second-look operation. Equally important are the frequency of serial determinations, a thorough understanding of the limitations of the assay, and careful evaluation of the clinical condi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90137-5
更新日期：1979-02-01 00:00:00
abstract：BACKGROUND:The unpredictability of prosthetic vascular access thrombosis precludes the scheduling of elective graft thrombectomy. This results in inconsistent dialysis for patients, as well as logistical challenges for dialysis clinics and surgeons, and increased cost. In an effort to solve this problem a community-wid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00133-6
更新日期：1999-08-01 00:00:00
abstract：:Various reports have demonstrated that the intraoperative utilization of the choledochoscope has significantly reduced the incidence of unsuspected retained common duct stones from approximately 10 percent to 0 to 2 percent. Our series revealed a 4 percent incidence of retained stones before choledochoscopy was utiliz...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90406-3
更新日期：1983-09-01 00:00:00
abstract：BACKGROUND:Conventional wisdom teaches that small hernia defects are more likely to incarcerate. We aim to identify radiographic features of ventral hernias associated with increased risk of bowel incarceration. METHODS:We assessed all patients who underwent emergent ventral hernia repair for bowel complications from ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.09.035
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:Despite efforts at standardization, evaluation and reporting of clerkships remains highly variable. This study reviews the current spectrum of surgical clerkship grading. METHODS:Data were reviewed for every medical school from which an application was received to a single surgery residency program in 2017 ...
journal_title：American journal of surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.amjsurg.2018.09.024
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Although neoadjuvant chemotherapy is increasingly used for breast cancer, if a patient has a complete clinical response, it is often difficult for the surgeon to know exactly where and how much breast tissue to remove. METHODS:A method is described where the edges of the tumor are tattooed prior to chemothe...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.009
更新日期：2007-10-01 00:00:00
abstract：:We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80618-x
更新日期：1990-01-01 00:00:00
abstract：:From these data and data from the literature, our recommended treatment for well-differentiated cancer is as follows: For papillary cancer, resection should be adequate to encompass the entire tumor, which in most cases would be complete lobectomy and possibly isthmusectomy. Prophylactic neck dissection is of no value...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90378-0
更新日期：1981-10-01 00:00:00
abstract：:In addition to its own inherent morbidity, the pain associated with chronic wounds presents a primary obstacle to healing. To initiate safe and effective therapy, we used a multidisciplinary approach that required the wound-healing clinician and pain-management practitioner to work together to diagnose and treat the p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(03)00289-7
更新日期：2004-07-01 00:00:00
abstract：BACKGROUND:We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. METHODS:Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fract...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.08.040
更新日期：2007-12-01 00:00:00
abstract：:Allergy to metal implants is under study at the Dartmouth-Hitchcock Medical Center using in vitro examination of white blood cell migration. Retrospective data from 121 patients confirm that allergic responses do occur. Prospective data are being gathered to investigate the incidence, prevalence and relation to morbid...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90323-2
更新日期：1980-04-01 00:00:00
abstract：BACKGROUND:Trauma readmissions have been well studied but little data exists regarding Emergency Department (ED) utilization following an injury. This study was performed to determine the factors associated with a return to the ED after trauma. METHODS:A retrospective review of all adult trauma patients evaluated betw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.10.046
更新日期：2020-07-01 00:00:00
abstract：:The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81192-4
更新日期：1992-11-01 00:00:00
abstract：BACKGROUND:Choledochal cysts (CDC) are rare congenital cystic lesions of the biliary tract. In North America the incidence of CDC is estimated as 1/150,000; it is not clear that the disease pattern in North America is similar to that in Asia. METHODS:Retrospective chart review. Statistical analysis was under taken usi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.01.025
更新日期：2005-05-01 00:00:00
abstract：BACKGROUND:Retroperitoneal vascular injury remains one of the most frequent causes of death following abdominal trauma. A risk analysis of the association between potential outcome predictors and mortality following abdominal aorta and inferior vena cava injuries was performed. METHODS:Eighty-nine patients sustaining ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00231-0
更新日期：1996-11-01 00:00:00
