Consensus in ERAS protocols for ventral hernia repair: evidence-based recommendations from the ACHQC QI Committee.

IF 2.6 2区 医学 Q1 SURGERY Hernia Pub Date : 2024-11-15 DOI:10.1007/s10029-024-03203-9
Daphne Remulla, Joel F Bradley, Winnie Henderson, Ronald C Lewis, Bridgette Kreuz, Lucas R Beffa
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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.

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腹股沟疝修补术 ERAS 方案共识:ACHQC QI 委员会提出的循证建议。
目的:加强术后恢复(ERAS)方案广泛应用于疝气患者的术后护理。尽管ERAS很普遍,但由于缺乏已发表的共识指南,因此在实践中存在很大的差异。本研究的目的是评估全美各机构在腹股沟疝修补术中使用的 ERAS 方案的要素,并为每个确定的要素提供共识建议:方法:腹部核心健康质量合作组织(ACHQC)质量改进(QI)委员会的机构成员提交了当前的 ERAS 协议。每个方案中的项目被归类为 "要素",然后指定一个主题。任何来自不同机构的≥ 2 个要素的主题都被标记为 "主题",然后按患者护理周期的阶段进行分组。除了 ACHQC QI 委员会的共识声明外,还提供了当前证据的简要回顾:结果:来自 6 家专门从事疝气护理的三级转诊中心的 295 个要素被汇编成 24 个主题,并按四个不同阶段进行分组:入院前优化、术前护理、术中护理和术后管理:本文对腹股沟疝修补术的 ERAS 方案进行了多机构审查,并确定了共同的主题,为疝气手术的统一 ERAS 方案提供了框架。未来的工作可能有助于制定专门针对增强腹股沟疝修补术恢复能力的社会指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hernia
Hernia SURGERY-
CiteScore
4.90
自引率
26.10%
发文量
171
审稿时长
4-8 weeks
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.
期刊最新文献
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