Dataset Information

The clinical application of enhanced recovery after surgery protocol in perioperative period of laparoscopic nephron sparing surgery.

ABSTRACT:

Background

The enhanced recovery after surgery (ERAS) program is focused on improving surgical outcomes and enhancing the patient experience before, during and after surgery. We performed this study to evaluate the effect of ERAS in perioperative period of laparoscopic nephron sparing surgery (LNSS).

Methods

A retrospective analysis of 287 consecutive patients with localized renal cell carcinoma (RCC) who underwent LNSS from December 2015 to June 2017 was conducted. Our study design included two cohorts. Patients underwent conventional care in one group (n=136), and ERAS protocol in the other group (n=151). The data of recovery of gastrointestinal function, catheter and drainage tube removal time, length of stay (LOS), hospitalization expenses and incidence of postoperative complications were compared between the two groups.

Results

Compared with conventional group, cases in ERAS group presented with shorter time of recovery of gastrointestinal function (P<0.05) and LOS (P<0.05), shorter catheter and drainage tube removal time (P<0.05), lower hospitalization expenses and lower perioperative complications (P<0.05).

Conclusions

Program of ERAS used in perioperative period of LNSS can apparently accelerate the time of postoperative recovery, reduce complications, shorten time stay in hospital and cut down the total cost, finally improve patients' satisfaction.

SUBMITTER: Tang M

PROVIDER: S-EPMC7475685 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

The clinical application of enhanced recovery after surgery protocol in perioperative period of laparoscopic nephron sparing surgery.

Tang Min M Dong Huiyu H Shao Pengfei P Li Jie J Wang Zengjun Z Liu Bianjiang B

Translational andrology and urology 20200801 4

<h4>Background</h4>The enhanced recovery after surgery (ERAS) program is focused on improving surgical outcomes and enhancing the patient experience before, during and after surgery. We performed this study to evaluate the effect of ERAS in perioperative period of laparoscopic nephron sparing surgery (LNSS).<h4>Methods</h4>A retrospective analysis of 287 consecutive patients with localized renal cell carcinoma (RCC) who underwent LNSS from December 2015 to June 2017 was conducted. Our study desi ...[more]

PMID: 32944519

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Project description:Background and objectiveNephron sparing surgery (NSS) is the preferred management for clinical stage T1 (cT1) renal masses. In recent years, indications have expanded to larger and more complex renal tumors. In an effort to provide optimal patient outcomes, urologists strive to achieve the pentafecta when performing partial nephrectomy. This has led to the continuous technologic advancement and technique refinement including the use of augmented reality, ultrasound techniques, changes in surgical approach and reconstruction, uses of novel fluorescence marker guided imaging, and implementation of early recovery after surgery (ERAS) protocols. The aim of this narrative review is to provide an overview of the recent advances in pre-, intra-, and post-operative management and approaches to managing patients with renal masses undergoing NSS.MethodsWe performed a non-systematic literature search of PubMed and MEDLINE for the most relevant articles pertaining to the outlined topics from 2010 to 2022 without limitation on study design. We included only full-text English articles published in peer-reviewed journals.Key content and findingsPartial nephrectomy is currently prioritized for cT1a renal masses; however, indications have been expanding due to a greater understanding of anatomy and technologic advances. Recent studies have demonstrated that improvements in imaging techniques utilizing cross-sectional imaging with three-dimensional (3D) reconstruction, use of color doppler intraoperative ultrasound, and newer studies emerging using contrast enhanced ultrasound play important roles in certain subsets of patients. While indocyanine green administration is commonly used, novel fluorescence-guided imaging including folate receptor-targeting fluorescence molecules are being investigated to better delineate tumor-parenchyma margins. Augmented reality has a developing role in patient and surgical trainee education. While pre-and intra-operative imaging have shown to be promising, near infrared guided segmental and sub-segmental vessel clamping has yet to show significant benefit in patient outcomes. Studies regarding reconstructive techniques and replacement of reconstruction with sealing agents have a promising future. Finally, ERAS protocols have allowed earlier discharge of patients without increasing complications while improving cost burden.ConclusionsAdvances in NSS have ranged from pre-operative imaging techniques to ERAS protocols Further prospective investigations are required to determine the impact of novel imaging, in-vivo fluorescence biomarker use, and reconstructive techniques on achieving the pentafecta of NSS.

Dataset Information

The clinical application of enhanced recovery after surgery protocol in perioperative period of laparoscopic nephron sparing surgery.

Background

Methods

Results

Conclusions

Publications

The clinical application of enhanced recovery after surgery protocol in perioperative period of laparoscopic nephron sparing surgery.

Similar Datasets

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