Bruna Esteban M, Vorwald P, Ortega Lucea S, Ramírez Rodríguez JM; Grupo de Trabajo de Cirugía Esofagogástrica del Grupo Español de Rehabilitación Multimodal (GERM). Enhanced recovery after surgery in gastric resections.
Cir Esp 2017;
95:73-82. [PMID:
28185641 DOI:
10.1016/j.ciresp.2016.10.013]
[Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/27/2016] [Accepted: 10/29/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION
Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery.
METHODS
According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery.
RESULTS
The measures to be applied are divided in a preoperative, perioperative and postoperative stage. This document provides recommendations concerning the appropriate information, limited fasting and administration of carbohydrate drinks 2hours before surgery, specialized anesthetic strategies, minimal invasive surgery, no routine use of drainages and tubes, mobilization and early oral tolerance during the immediate postoperative period, as well as criteria for discharge.
CONCLUSIONS
The application of a protocol of enhanced recovery after surgery in resective gastric surgery can improve and accelerate the functional recovery of our patients, requiring an appropriate multidisciplinary coordination, the evaluation of obtained results with the application of these measures and the investigation of controversial topics about which we currently have limited evidence.
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