Daphne Remulla, Joel F Bradley, Winnie Henderson, Ronald C Lewis, Bridgette Kreuz, Lucas R Beffa
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引用次数: 0
Abstract
Purpose: Enhanced recovery after surgery (ERAS) protocols are widely used in the post-operative care of hernia patients. Despite their prevalence, an absence of published consensus guidelines creates significant heterogeneity in practices. The aim of this study was to evaluate elements in ERAS protocols utilized in ventral hernia repair from institutions across the United States and provide consensus recommendations for each identified element.
Methods: Institutional members of the Abdominal Core Health Quality Collaborative (ACHQC) Quality Improvement (QI) committee submitted current ERAS protocols. Items within each protocol were classified as "elements", then assigned a topic. Any topic with ≥ 2 elements from separate institutions were labeled as a "theme," then grouped by stage in the patient care cycle. A brief review of current evidence was provided in addition to a ACHQC QI committee consensus statement.
Results: A total of 295 elements from 6 tertiary referral centers specializing in hernia care were compiled into 24 themes and grouped by four separate stages: Pre-Admission Optimization, Pre-Operative Care, Intra-operative Care, and Post-Operative Management.
Conclusion: This article represents a multi-institutional review of ERAS protocols for ventral hernia repair and identifies common themes that may provide the framework for a unified ERAS protocol in hernia surgery. Future work may serve to develop societal guidelines defined specifically for enhanced recovery in ventral hernia repair.
期刊介绍:
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.