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Thierry G, Beck F, Hardy PY, Kaba A, Blanjean A, Vandermeulen M, Honoré P, Joris J, Bonhomme V, Detry O. Impact of enhanced recovery program implementation on postoperative outcomes after liver surgery: a monocentric retrospective study. Surg Endosc 2024:10.1007/s00464-024-10796-w. [PMID: 38653900 DOI: 10.1007/s00464-024-10796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/10/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION It is still unclear whether enhanced recovery programs (ERPs) reduce postoperative morbidity after liver surgery. This study investigated the effect on liver surgery outcomes of labeling as a reference center for ERP. MATERIALS AND METHODS Perioperative data from 75 consecutive patients who underwent hepatectomy in our institution after implementation and labeling of our ERP were retrospectively compared to 75 patients managed before ERP. Length of hospital stay, postoperative complications, and adherence to protocol were examined. RESULTS Patient demographics, comorbidities, and intraoperative data were similar in the two groups. Our ERP resulted in shorter length of stay (3 days [1-6] vs. 4 days [2-7.5], p = 0.03) and fewer postoperative complications (24% vs. 45.3%, p = 0.0067). This reduction in postoperative morbidity can be attributed exclusively to a lower rate of minor complications (Clavien-dindo grade < IIIa), and in particular to a lower rate of postoperative ileus, after labeling. (5.3% vs. 25.3%, p = 0.0019). Other medical and surgical complications were not significantly reduced. Adherence to protocol improved after labeling (17 [16-18] vs. 14 [13-16] items, p < 0.001). CONCLUSIONS The application of a labeled enhanced recovery program for liver surgery was associated with a significant shortening of hospital stay and a halving of postoperative morbidity, mainly ileus.
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Affiliation(s)
- Gabriel Thierry
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium.
- Groupe Francophone de Réhabilitation Améliorée Après Chirurgie (GRACE ; Francophone Group for Enhanced Recovery After Surgery), Beaumont, France.
- Inflammation and Enhanced Rehabilitation Laboratory (Regional Anesthesia and Analgesia), GIGA-I3 Thematic Unit, GIGA-Research, Liege University, Liege, Belgium.
- CREDEC: Centre de Recherche et d'Enseignement du Département de Chirurgie GIGA Metabolism, University of Liege, Domaine du Sart Tilman, Liege, Belgium.
| | - Florian Beck
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIG-Consciousness Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
| | - Pierre-Yves Hardy
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Groupe Francophone de Réhabilitation Améliorée Après Chirurgie (GRACE ; Francophone Group for Enhanced Recovery After Surgery), Beaumont, France
- Inflammation and Enhanced Rehabilitation Laboratory (Regional Anesthesia and Analgesia), GIGA-I3 Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
| | - Abdourahamane Kaba
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Inflammation and Enhanced Rehabilitation Laboratory (Regional Anesthesia and Analgesia), GIGA-I3 Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
| | - Arielle Blanjean
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Groupe Francophone de Réhabilitation Améliorée Après Chirurgie (GRACE ; Francophone Group for Enhanced Recovery After Surgery), Beaumont, France
| | - Morgan Vandermeulen
- Department of Abdominal Surgery and Transplantation, Liege University Hospital, Liege, Belgium
- CREDEC: Centre de Recherche et d'Enseignement du Département de Chirurgie GIGA Metabolism, University of Liege, Domaine du Sart Tilman, Liege, Belgium
| | - Pierre Honoré
- Department of Abdominal Surgery and Transplantation, Liege University Hospital, Liege, Belgium
| | - Jean Joris
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Groupe Francophone de Réhabilitation Améliorée Après Chirurgie (GRACE ; Francophone Group for Enhanced Recovery After Surgery), Beaumont, France
| | - Vincent Bonhomme
- Department of Anesthesia and Intensive Care Medicine, Liege University Hospital, Liege, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIG-Consciousness Thematic Unit, GIGA-Research, Liege University, Liege, Belgium
| | - Olivier Detry
- Department of Abdominal Surgery and Transplantation, Liege University Hospital, Liege, Belgium
- CREDEC: Centre de Recherche et d'Enseignement du Département de Chirurgie GIGA Metabolism, University of Liege, Domaine du Sart Tilman, Liege, Belgium
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Hardy PY, Bodson A, De Harenne C, Hans G, Joris J. Impact of preoperative treatment with antidepressants and/or anxiolytics on outcomes after colorectal surgery with an enhanced recovery programme: a monocentric retrospective study . Acta Chir Belg 2023; 123:54-61. [PMID: 34121612 DOI: 10.1080/00015458.2021.1940727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Preoperative use of antidepressants and anxiolytics was reported to increase length of hospital stay (LOS) and worsen surgical outcomes. However, the surgical procedures studied were seldom performed with an enhanced recovery programme (ERP). This study investigated whether these medications impaired postoperative recovery after colorectal surgery with an ERP. METHODS The data of all patients scheduled for colorectal surgery between November 2015 and December 2019 prospectively included in our database were analysed. All the patients were managed with the same ERP. Demographic data, risk factors, incidence of postoperative complications, LOS, and adherence to the ERP were compared between patients with and without preoperative antidepressant and/or anxiolytic treatment. RESULTS Of the 502 patients, 157 (31.3%) were treated with antidepressants and/or anxiolytics. They were older (65.7 vs. 59.5 years, p < 0.001), sicker (higher ASA physical status score, p = 0.001), and underwent surgery more frequently for cancer (73.9 vs. 56.8%, p < 0.001). Overall adherence to ERP (p = 0.99) and adherence to the postoperative items of ERP (p = 0.29), incidence of postoperative complications (35.7 vs. 33.2%, p = 0.61), and LOS (4 [2-7] vs. 4 [2-7], p = 0.99) were similar in the two groups. CONCLUSIONS Our findings suggest that preoperative treatment with antidepressants and/or anxiolytics does not worsen outcome after elective colorectal surgery with an ERP, does not impact adherence to ERP, and does not prolong LOS. ERP seems efficacious in patients treated with these medications, who should therefore not be excluded from this programme.
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Affiliation(s)
- Pierre-Yves Hardy
- Department of Anesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium.,Groupe francophone de réhabilitation améliorée après chirurgie, Beaumont, France
| | - Aurélie Bodson
- Department of Anesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
| | - Charlotte De Harenne
- Department of Anesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
| | - Grégory Hans
- Department of Anesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
| | - Jean Joris
- Department of Anesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium.,Groupe francophone de réhabilitation améliorée après chirurgie, Beaumont, France
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Hardy PY, Fikri J, Libbrecht D, Louis E, Joris J. Pain Characteristics in Patients with Inflammatory Bowel Disease: A Monocentric Cross-Sectional Study. J Crohns Colitis 2022; 16:1363-1371. [PMID: 35380673 DOI: 10.1093/ecco-jcc/jjac051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/14/2022] [Accepted: 03/30/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The abdominal pain common in inflammatory bowel disease [IBD] patients is traditionally associated with inflammation but may persist during clinical remission. Central sensitization [CS] has not previously been explored in these patients. This study aimed to determine the epidemiology of pain in IBD patients and to specify pain characteristics with particular attention to CS. METHODS This cross-sectional study included 200 patients; 67% had Crohn's disease [CD]. Pain was assessed using the McGill questionnaire, using the Douleur Neuropathique 4 [DN4] questionnaire and by clinical examination. Its impacts on quality of life, depression and anxiety were also assessed. RESULTS Three-quarters of IBD patients complained of pain, including intermittent pain attacks, 62% reported abdominal pain and 17.5% had CS. The prevalence of pain [83.6% vs 59.1%; p < 0.001] and abdominal pain [68.7% vs 48.5%; p = 0.006] was higher in CD patients than in ulcerative colitis [UC] patients. Multivariate analysis confirmed that age [p = 0.02], sex [female] [p = 0.004] and CD [p = 0.005] were independent risk factors for pain. Pain intensity was greater in the case of CS (6 [5-3] vs 3 [1.5-5], p < 0.003) which significantly impaired quality of life [p < 0.003] compared with pain without CS. CONCLUSIONS The prevalence of pain was high in IBD patients [≈75%] and higher in CD patients. Significant impacts on quality of life were confirmed. More than 25% of patients with abdominal pain described CS as responsible for more severe pain and worsened quality of life. TRIAL REGISTRATION REF NCT04488146.
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Affiliation(s)
- Pierre-Yves Hardy
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
| | - Jalal Fikri
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
| | - Dominique Libbrecht
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium.,Pain Clinic, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
| | - Edouard Louis
- Service of Gastroenterology, Hepatology, and Digestive Oncology, CHU Liège, University of Liège, domaine universitaire du Sart-Tilman, Liège, Belgium
| | - Jean Joris
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
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Deschaumes O, Hubert M, Hardy PY. [Soft tissue necrotizing infection]. Rev Med Liege 2022; 77:77-79. [PMID: 35143125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Necrotizing fasciitis and gas gangrene represent a rapidly progressive and fatal tissue infection in the absence of early multidisciplinary treatment. There are multiple risk factors, but diabetes remains the main one. The presence of crackles or extensive lesions are an indication for exploration and surgical treatment. Conservative management is associated with zero survival. Iconography, biology or bacteriology can help in the diagnosis, but the latter is only made during surgery. The associated mortality is high, despite appropriate management. We report here the case of a diabetic patient requiring insulin, having presented this pathology, the starting point of which is a traumatic wound, with an extensive acute course, contra-indicating any surgical procedure.
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Affiliation(s)
| | - M Hubert
- Service d'Anesthésie-Réanimation, CHU, Liège, Belgique
| | - P Y Hardy
- Service d'Anesthésie-Réanimation, CHU, Liège, Belgique
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Iancu A, Hardy PY, Coimbra C, Joris J. [Ambulatory laparoscopic colectomy : First experiences at the CHU of Liège]. Rev Med Liege 2021; 76:875-878. [PMID: 34881831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
CONTEXT For many years, enhanced recovery programs (ERP) for colorectal surgery have been developed in many hospitals around the world. Recently, our institution took a new step forward in colonic surgery : ambulatory laparoscopic colectomies. METHODS Our eligibility criteria for our ambulatory colectomy program were defined and our perioperative ERP protocol was adapted to the ambulatory setting. Five patients consented to inclusion in this program. RESULTS Patients' characteristics were as follows : four women, one male, age : 48 years (range 21-67); surgical indication : cancer in two patients, diverticulitis in two patients, and Crohn disease in one patient. The surgical site was the left colon in four cases and the right colon in one case. Four out of the five patients left the hospital 5-8 h after the end of the surgery. No postoperative complication occurred, no readmission was necessary. DISCUSSION This article discusses the benefits and risks of ambulatory colectomy. We emphasize that such outpatient management must not be pursued at the expense of the patient's safety and well-being.
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Affiliation(s)
- A Iancu
- Service d'Anesthésie et Réanimation, CHU Liège, Belgique
| | - P Y Hardy
- Service d'Anesthésie et Réanimation, CHU Liège, Belgique
- Groupe francophone de Réhabilitation Améliorée après Chirurgie (GRACE), Beaumont, France
| | - C Coimbra
- Service de Chirurgie digestive, CHU Liège, Belgique
| | - J Joris
- Service d'Anesthésie et Réanimation, CHU Liège, Belgique
- Groupe francophone de Réhabilitation Améliorée après Chirurgie (GRACE), Beaumont, France
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Meunier A, Sorce G, Hardy PY, Coimbra C, Decker E, Joris J. Comparison of outcome after right colectomy with an enhanced recovery programme in patients with inflammatory bowel disease and patients operated on for other conditions: a monocentric retrospective study. Int J Colorectal Dis 2021; 36:757-763. [PMID: 33423143 DOI: 10.1007/s00384-020-03830-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/25/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Enhanced recovery programmes (ERPs) after surgery reduce postoperative complications and hospital stay. Patients with inflammatory bowel disease (IBD) often present risk factors for postoperative complications. This accounts for reluctance to include them in ERPs. We compared outcome after right colectomy with an ERP in IBD and non-IBD patients. METHODS In our GRACE colorectal surgery database comprising 508 patients, we analysed patients scheduled for right colectomy (n = 160). Adherence to the protocol, postoperative complications and length of hospital stay of IBD patients (n = 45) were compared with those of non-IBD patients (n = 115). Data (mean ± SD, median [IQR], count (%)) were compared by Student's t, Mann-Whitney U and chi-square tests when appropriate; p < 0.05 taken as statistically significant. RESULTS IBD patients were significantly younger (38.9 ± 13.8 vs. 58.9 ± 18.5 years, p < 0.001) and had lower BMI (23.0 ± 5.0 vs. 25.1 ± 5.0 kg m-2, p < 0.01). Adherence to ERP was similar in the two groups. Resumption of eating on the day of the operation was less well tolerated (73.3% vs. 85.2%, p < 0.05) and postoperative pain (p < 0.001) was greater in IBD patients. The incidence of postoperative complications (13.3% vs. 17.3%) and the length of hospital stay (3 [3-4.5] vs. 3 [2-5] days) were comparable in IBD and non-IBD patients, respectively. CONCLUSION The management of IBD patients in an ERP is not only feasible but also indicated. These patients benefit as much from ERP as non-IBD patients.
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Affiliation(s)
- Anne Meunier
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l'hôpital Bat B35, B-4000, Liège, Belgium
| | - Giuseppe Sorce
- Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium
| | - Pierre-Yves Hardy
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l'hôpital Bat B35, B-4000, Liège, Belgium
| | - Carla Coimbra
- Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium
| | - Emmanuel Decker
- Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium
| | - Jean Joris
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l'hôpital Bat B35, B-4000, Liège, Belgium. .,Groupe francophone de réhabilitation améliorée après chirurgie (GRACE; Francophone group for enhanced recovery after surgery, www.grace-asso.fr), Beaumont, France.
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Meunier A, Sorce G, Hardy PY, Coimbra C, Decker E, Joris J. Correction to: Comparison of outcome after right colectomy with an enhanced recovery programme in patients with inflammatory bowel disease and patients operated on for other conditions: a monocentric retrospective study. Int J Colorectal Dis 2021; 36:765. [PMID: 33507365 DOI: 10.1007/s00384-021-03853-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Anne Meunier
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l'hôpital Bat B35, B-4000, Liège, Belgium
| | - Giuseppe Sorce
- Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium
| | - Pierre-Yves Hardy
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l'hôpital Bat B35, B-4000, Liège, Belgium
| | - Carla Coimbra
- Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium
| | - Emmanuel Decker
- Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium
| | - Jean Joris
- Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l'hôpital Bat B35, B-4000, Liège, Belgium. .,Groupe francophone de réhabilitation améliorée après chirurgie (GRACE; Francophone group for enhanced recovery after surgery, www.grace-asso.fr), Beaumont, France.
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Hardy PY, Hallet C, Kirsch M, Samalea Suarez N, Hick G, Petry J, Lois F, Jastrowicz J, Depierreux F. Anesthetic Management of a Child With Rapid-Onset Dystonia-Parkinsonism (DYT12-ATP1A3): A Case Report. A A Pract 2021; 15:e01440. [PMID: 33783371 DOI: 10.1213/xaa.0000000000001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Rapid-onset dystonia-parkinsonism also known as DYT12-ATP1A3 is an extremely rare neurological disease. Patients develop dystonia, bradykinesia, postural instability, dysarthria, and dysphagia. Injection of botulinum toxin is the first-choice treatment for focal dystonia. We report the case of a 14-year-old patient diagnosed with rapid-onset dystonia-parkinsonism who was scheduled for injection of botulinum toxin in his upper limbs under general anesthesia. To our knowledge, there is no previous report about the anesthetic management of patients with rapid-onset dystonia-parkinsonism.
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Affiliation(s)
| | - Claude Hallet
- From the Departments of Anesthesiology and Reanimation and
| | | | | | - Gaëtane Hick
- From the Departments of Anesthesiology and Reanimation and
| | - Jorgen Petry
- From the Departments of Anesthesiology and Reanimation and
| | - Fernande Lois
- From the Departments of Anesthesiology and Reanimation and
| | | | - Frédérique Depierreux
- Neurology, Centre Hospitalier Universitaire Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium
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Depierreux F, Parmentier E, Hardy PY, Leroy P, Maquet P. Successful treatment of hand dystonia with botulinum toxin in a DYT12 patient. Toxicon 2021. [DOI: 10.1016/j.toxicon.2020.11.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Hardy PY, Meunier A, Coimbra C, Decker E, Joris J. [Enhanced recovery after surgery in colorectal surgery]. Rev Med Liege 2020; 75:286-291. [PMID: 32496668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Enhanced recovery after surgery (ERAS) in colorectal surgery consists of multidisciplinary, multimodal, and patient-centred care. The implementation of pre-, intra-, and post-operative measures mitigates the surgical stress, the inflammatory reaction, and their consequences. The elements of this protocol are evidence-based medicine. This allows improved and accelerated recovery. Consequently, ERAS reduces the incidence of medical complications by 50 %, including fewer infectious complications, and a possible positive impact on survival after oncologic surgery. Hospital length of stay is shortened. There is no contraindication to ERAS, which must be used for all patients undergoing colorectal surgery. Adaptation of the protocol will nevertheless be necessary in the event of urgent surgery.
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Affiliation(s)
- P Y Hardy
- Service d'Anesthésie-réanimation, CHU Liège, Belgique
| | - A Meunier
- Service d'Anesthésie-réanimation, CHU Liège, Belgique
| | - C Coimbra
- Service de Chirurgie digestive, CHU Liège, Belgique
| | - E Decker
- Service de Chirurgie digestive, CHU Liège, Belgique
| | - J Joris
- Service d'Anesthésie-réanimation, CHU Liège, Belgique
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Depierreux F, Jedidi H, Hardy PY, Parmentier E, Garraux G. [How to explore… a cervical dystonia]. Rev Med Liege 2020; 75:121-124. [PMID: 32030938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cervical dystonia is one of the most frequent form of focal dystonia. However, there's a great lack of awareness of this condition : a long delay to diagnosis is quite common and misdiagnosis is often seen. Nevertheless, this pathology is invalidating and improving diagnosis could have an impact on the treatment and the patient's quality of life.
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Affiliation(s)
- F Depierreux
- Groupe MoVeRe, Service de Neurologie, CHU Liège, Belgique
| | - H Jedidi
- Service de Neurologie, Clinique ISoSL, Liège, Belgique
| | - P Y Hardy
- Service d'Anesthésie, CHU Liège, Belgique
| | - E Parmentier
- Groupe MoVeRe, Service de Neurologie, CHU Liège, Belgique
| | - G Garraux
- Groupe MoVeRe, Service de Neurologie, CHU Liège, Belgique
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Hardy PY, Depierreux F, Ferretti C. [Acute pulmonary edema and tocolytic therapy in pregnant women : clinical case and review of literature.]. Rev Med Liege 2019; 74:129-133. [PMID: 30897311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We report the case of a pregnant woman, treated by nifedipine and next by atosiban for premature labour, who develop an acute pulmonary edema. The severity of symptoms and hypoxemia lead the patient to a cesarean and next to the intensive care hospitalization. This clinical case allow us to make a review of literature and reminds us the differential diagnosis to look for during an acute dyspnea in a pregnant woman and the treatment of acute pulmonary edema in these circumstances. The pathophysiological mechanisms which are at the origins of this condition and the implication of the tocolytic treatment will also be discussed.
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Affiliation(s)
- P Y Hardy
- Service d'Anesthésie-Réanimation, CHU Liège, Belgique
| | | | - C Ferretti
- Chef de Service des Soins intensifs, Centre Hospitalier Luxembourgeois, Luxembourg
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