ABSTRACT
The perioperative management of patients undergoing abdominal surgery has been based on traditional concepts and often not supported by scientific evidence. Recently there have been several scientific studies showing that some traditional procedures for the perioperative management of patients as preoperative fasting, bowel preparation, use of naso-gastric tubes, placement of intra-abdominal drainage, postoperative fasting etc. They are unnecessary and sometimes counterproductive. Perioperative management protocols ERAS or Fast-Track (Enhanced Recovery After Surgery) are based on the use in the perioperative period of measures that are supported by current scientific evidence. Since 2000 appear in the scientific literature several works that reflect the application of protocols ERAS or Fast- Track in surgery of the digestive system where it's shown uniformly, not only the security of your application but also, decreased complications and hospital stay. Although initially these protocols were described in colorectal surgery, due to the good results obtained, the application of these protocols has rapidly expanded to other surgical specialties such as thoracic surgery, Urology, Gynaecology, etc. In all these specialties has unanimously showing improved postoperative recovery with ERAS application protocols. The purpose of this paper is twofold. On the one hand examine the scientific evidence that exists today on the most important elements of an ERAS program and present preliminary results of the implementation of a program ERAS in our hospital.
Subject(s)
Liver/surgery , Postoperative Care/methods , Humans , Nutritional Support , Patient Care Team , Recovery of FunctionABSTRACT
El manejo perioperatorio de los pacientes sometidos a cirugía abdominal se ha basado en conceptos tradicionales y frecuentemente no avalados por la evidencia científica. Recientemente han aparecido varios estudios científicos que demuestran que algunos procedimientos tradicionales para el manejo perioperatororio de los pacientes como, el ayuno preoperatorio, la preparación intestinal, el uso de sondas naso-gástricas, la colocación de drenajes intraabdominales, el ayuno en el postoperatorio etc., son innecesarios e incluso a veces contraproducentes. Los protocolos de manejo perioperatorio de ERAS o Fast-Track (Enhanced Recovery After Surgery) se basan en la utilización de medidas en el periodo perioperatorio que están avaladas por la evidencia científica actual. A partir del año 2000 empiezan a aparecer en la bibliografía científica varios trabajos que recogen la aplicación de protocolos ERAS o Fast- Track en la cirugía del aparato digestivo en los que se nuestra de manera uniforme, no solo la seguridad de su aplicación sino también, la disminución de las complicaciones y de la estancia postoperatoria. Aunque inicialmente estos protocolos fueron descritos en la cirugía colo-rectal, debido a los buenos resultados obtenidos, la aplicación de estos protocolos se ha expandido rápidamente a otras especialidades quirúrgicas como la cirugía torácica, la Urología, la Ginecología, etc. En todos estas especialidades se ha mostrando de forma unánime la mejoría de la recuperación postoperatoria con la aplicación de protocolos ERAS. El motivo de este artículo es doble. Por un lado examinar la evidencia científica que existe en la actualidad sobre los elementos mas importantes de un programa ERAS y presentar los resultados preliminares de la implantación (AU)
The perioperative management of patients undergoing abdominal surgery has been based on traditional concepts and often not supported by scientific evidence. Recently there have been several scientific studies showing that some traditional procedures for the perioperative management of patients as preoperative fasting, bowel preparation, use of naso-gastric tubes, placement of intra-abdominal drainage, postoperative fasting etc. They are unnecessary and sometimes counterproductive. Perioperative management protocols ERAS or FastTrack (Enhanced Recovery After Surgery) are based on the use in the perioperative period of measures that are supported by current scientific evidence. Since 2000 appear in the scientific literature several works that reflect the application of protocols ERAS or Fast- Track in surgery of the digestive system where it´s shown uniformly, not only the security of your application but also, decreased complications and hospital stay. Although initially these protocols were described in colorectal surgery, due to the good results obtained, the application of these protocols has rapidly expanded to other surgical specialties such as thoracic surgery, Urology, Gynaecology, etc. In all these specialties has unanimously showing improved postoperative recovery with ERAS application protocols. The purpose of this paper is twofold. On the one hand examine the scientific evidence that exists today on the most important elements of an ERAS program and present preliminary results of the implementation of a program ERAS in our hospital (AU)
