共 32 条
Enhanced Recovery After Surgery (ERAS) Pathway in Esophagectomy Is a Reasonable Prediction of Hospital Stay Possible?
被引:29
作者:

Parise, Paolo
论文数: 0 引用数: 0
h-index: 0
机构:
Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Ferrari, Carlo
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h-index: 0
机构:
Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Cossu, Andrea
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h-index: 0
机构:
Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Puccetti, Francesco
论文数: 0 引用数: 0
h-index: 0
机构:
Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Elmore, Ugo
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h-index: 0
机构:
Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

De Pascale, Stefano
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机构:
ASST Spedali Civili, 2 Gen Surg Unit, Upper Gastrointestinal Surg Unit, Brescia, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Garutti, Leonardo
论文数: 0 引用数: 0
h-index: 0
机构:
Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Fumagalli, Uberto Romario
论文数: 0 引用数: 0
h-index: 0
机构:
ASST Spedali Civili, 2 Gen Surg Unit, Upper Gastrointestinal Surg Unit, Brescia, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Di Serio, Mariaclelia Stefania
论文数: 0 引用数: 0
h-index: 0
机构:
Univ Vita Salute San Raffaele, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy

Rosati, Riccardo
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h-index: 0
机构:
Univ Vita Salute San Raffaele, San Raffaele Hosp, Dept Gastrointestinal Surg, Milan, Italy Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy
机构:
[1] Osped San Raffaele, Dept Gastrointestinal Surg, Milan, Italy
[2] ASST Spedali Civili, 2 Gen Surg Unit, Upper Gastrointestinal Surg Unit, Brescia, Italy
[3] Univ Vita Salute San Raffaele, Milan, Italy
[4] Univ Vita Salute San Raffaele, San Raffaele Hosp, Dept Gastrointestinal Surg, Milan, Italy
关键词:
enhanced recovery;
ERAS pathways;
esophageal cancer;
esophagectomy;
COLORECTAL SURGERY;
CLINICAL PATHWAY;
CANCER;
OUTCOMES;
MORTALITY;
PROTOCOL;
PROGRAM;
COHORT;
D O I:
10.1097/SLA.0000000000002775
中图分类号:
R61 [外科手术学];
学科分类号:
摘要:
Objective: To assess whether perioperative variables or deviation from enhanced recovery after surgery (ERAS) items could be associated with delayed discharge after esophagectomy, and to convert them into a scoring system to predict it. Summary Background Data: ERAS perioperative pathways have been recently applied to esophageal resections. However, low adherence to ERAS items and high rates of protocol deviations are often reported. Methods: All patients who underwent esophagectomy between April 2012 and March 2017 were managed with a standardized perioperative pathway according to ERAS principles. The target length of stay was set at eighth postoperative day (POD). All significant variables at bivariate analysis were entered into a logistic regression to produce a predictive score. An initial validation of the score accuracy was carried out on a separate patient sample. Results: Two hundred eighty-six patients were included in the study. Multivariate regression analysis showed that American Society of Anesthesiology score >= 3, surgery duration > 255 min, "nonhybrid'' esophagectomy, and failure to mobilize patients within 24 h from surgery were associated with delayed discharge. The logistic regression model was statistically significant (P < 0.001) and correctly classified 81.9% of cases. The sensitivity was 96.6%, and the specificity was 17.6%. The prediction score applied to 23 patients correctly identified 100% of those discharged after eighth POD. Conclusions: The results of this study seem to be clinically meaningful and in linewith those fromother studies. The initial validation revealed good predictive properties.
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页码:77 / 83
页数:7
相关论文
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Churchill Hosp, Oxford OesophagoGastr Ctr, Oxford OX3 7LJ, England Churchill Hosp, Oxford OesophagoGastr Ctr, Oxford OX3 7LJ, England

Marshall, Robert E. K.
论文数: 0 引用数: 0
h-index: 0
机构:
Churchill Hosp, Oxford OesophagoGastr Ctr, Oxford OX3 7LJ, England Churchill Hosp, Oxford OesophagoGastr Ctr, Oxford OX3 7LJ, England

Maynard, Nicholas D.
论文数: 0 引用数: 0
h-index: 0
机构:
Churchill Hosp, Oxford OesophagoGastr Ctr, Oxford OX3 7LJ, England Churchill Hosp, Oxford OesophagoGastr Ctr, Oxford OX3 7LJ, England
[10]
Retrospective cohort study of an enhanced recovery programme in oesophageal and gastric cancer surgery
[J].
Gatenby, P. A. C.
;
Shaw, C.
;
Hine, C.
;
Scholtes, S.
;
Koutra, M.
;
Andrew, H.
;
Hacking, M.
;
Allum, W. H.
.
ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND,
2015, 97 (07)
:502-507

Gatenby, P. A. C.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Shaw, C.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Hine, C.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Scholtes, S.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Koutra, M.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Andrew, H.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Hacking, M.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England

Allum, W. H.
论文数: 0 引用数: 0
h-index: 0
机构:
Royal Marsden NHS Fdn Trust, London, England Royal Marsden NHS Fdn Trust, London, England