Introduction: The enhanced recovery program (ERP) is a management mode whose objective is to reduce the risk of complications and allow the patient to recover more quickly all its functional capacities and to reintegrate at most quickly and safely in his usual environment. This intentionally synthetic document aims to disseminate in the urological community the main points of the ERP recommendations for cystectomy. This work, coordinated by AFU, involves several other partners. The full document is available on the "Urofrance" website. Another article will follow on organizational measures.
Method: The development of the recommendations is based on the method "formalized consensus of experts" proposed by the HAS. The report is based on a systematic review of the literature (January 2006-May 2017), two rounds of iterative quotations and a national proofreading. Levels of proof of conclusions and gradation of recommendations are based on the HAS grid.
Results: The bibliographic strategy made it possible to retain 298 articles. Only the recommendations that obtained a strong agreement after the two rounds of iterative listing were retained. The recommendations presented here are in chronological form (before, during, after hospitalization). Twenty-six key points on the technical and organizational measures of ERP have been identified.
Conclusion: The result of the literature review, supplemented by expert opinion, suggests a significant clinical interest in the application and dissemination of ERP for cystectomy, despite the limited data available for this indication.
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http://dx.doi.org/10.1016/j.purol.2018.12.002 | DOI Listing |
Best Pract Res Clin Anaesthesiol
March 2024
Department of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. Electronic address:
This review documents the importance of postoperative interventions that accelerate the functional recovery of the thoracic surgical patient. Enhanced recovery after surgery (ERAS) pathways aim to mitigate the harmful surgical stress response. Improvements to the entire patient pathway, by removing unnecessary care elements while introducing evidence-based interventions, have synergistic effects.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, Department of Anesthesia and Critical Care Medicine, 1275 York Avenue, New York, NY, 10028, USA. Electronic address:
The objectives of this minireview are two-fold. The first is to discuss the evolution of opioid analgesia in perioperative medicine in the context of thoracic non-cardiac surgery. Current standard-of-care, aiming to optimize analgesia and limit undesirable side effects, is discussed in the context of multimodal analgesia, specifically enhanced recovery after thoracic surgery pathways.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology, Columbia University, 622 W 168th St, New York, 10032, NY, United States. Electronic address:
Effective pain control is crucial in the management of thoracic surgical patients since it reduces postoperative morbidity and promotes recovery. These patients have co-existing respiratory diseases and impaired pulmonary function, which may be further impaired by surgery. With the adoption of minimally invasive surgical techniques and an emphasis on enhancing recovery after surgery, multimodal analgesia has gained popularity as a way to reduce perioperative opioid use and its associated adverse events such as respiratory depression.
View Article and Find Full Text PDFBest Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Leuven, Belgium.
Caesarean delivery is the most performed inpatient surgery worldwide, with rates expected to rise. Optimising maternal recovery benefits not only the mother, but also the newborn and society. Enhanced Recovery After Caesarean delivery (ERAC) protocols standardize the approach to perioperative management of patients in order to accelerate early postoperative maternal rehabilitation.
View Article and Find Full Text PDFAdv Sci (Weinh)
January 2025
Research Institute for Intelligent Wearable Systems, School of Fashion and Textiles, The Hong Kong Polytechnic University, Kowloon, 999077, China.
Rapid temperature contrast hydrotherapy by water immersion has been utilized by athletes for effective sports recovery. However, its application at some training or competition venues is limited by high water consumption, bucky size, personal hygiene, and inconvenience. Here, a novel portable system equipped with highly effective, lightweight, and hygienic wearable fluidic fabric device is reported, that replaces direct water immersion.
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