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Association between use of enhanced recovery after surgery protocols and postoperative complications after gastric surgery for cancer (POWER 4): a nationwide, prospective multicentre study.
Ripollés-Melchor, Javier; Abad-Motos, Ane; Bruna-Esteban, Marcos; García-Nebreda, María; Otero-Martínez, Isabel; Abdel-Lah Fernández, Omar; Tormos-Pérez, María P; Paseiro-Crespo, Gloria; García-Álvarez, Raquel; A Mayo-Ossorio, María; Zugasti-Echarte, Orreaga; Nespereira-García, Paula; Gil-Gómez, Lucia; Logroño-Ejea, Margarita; Risco, Raquel; Parreño-Manchado, Felipe C; Gil-Trujillo, Silvia; Benito, Carmen; Jericó, Carlos; De-Miguel-Cabrera, María I; Ugarte-Sierra, Bakarne; Barragán-Serrano, Cristina; García-Erce, José A; Muñoz-Hernández, Henar; Río-Fernández, Sabela Del-; Herrero-Bogajo, María L; Espinosa-Moreno, Alma M; Concepción-Martín, Vanessa; Zorrilla-Vaca, Andrés; Vaquero-Pérez, Laura; Mojarro, Irene; Llácer-Pérez, Manuel; Gómez-Viana, Leticia; Fernández-Martín, María T; Abad-Gurumeta, Alfredo; Ferrando-Ortolà, Carlos; Ramírez-Rodríguez, José M; Aldecoa, César.
Afiliación
  • Ripollés-Melchor J; Department of Anaesthesia and Perioperative Medicine, Infanta Leonor University Hospital, Madrid, Spain; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Universidad Complutense de Madrid, Madrid, Spain.
  • Abad-Motos A; Department of Anaesthesia and Perioperative Medicine, Infanta Leonor University Hospital, Madrid, Spain; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain. Electronic address: ane.abadmotos@osakidetza.eus.
  • Bruna-Esteban M; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of General Surgery, La Fe University Hospital, Valencia, Spain.
  • García-Nebreda M; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Universidad Complutense de Madrid, Madrid, Spain; Department of General Surgery, Infanta Leonor University Hospital, Madrid, Spain.
  • Otero-Martínez I; Department of General Surgery, Hospital Álvaro Cunqueiro de Vigo (Complejo Hospitalario Universitario de Vigo), Vigo, Spain.
  • Abdel-Lah Fernández O; Department of General Surgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
  • Tormos-Pérez MP; Department of Anaesthesia and Perioperative Medicine, Vall d'Hebrón University Hospital, Barcelona, Spain.
  • Paseiro-Crespo G; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Universidad Complutense de Madrid, Madrid, Spain; Department of General Surgery, Infanta Leonor University Hospital, Madrid, Spain.
  • García-Álvarez R; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, 12 de Octubre University Hospital, Madrid, Spain.
  • A Mayo-Ossorio M; Department of General Surgery, Hospital Universitario Puerta del Mar Cádiz, Cádiz, Spain.
  • Zugasti-Echarte O; Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Navarra, Pamplona, Spain.
  • Nespereira-García P; Department of Anaesthesia and Perioperative Medicine, Hospital POVISA Vigo, Vigo, Spain.
  • Gil-Gómez L; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, Hospital de Sant Joan Despí Moisès Broggi, Spain.
  • Logroño-Ejea M; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, Hospital Universitario de Alava, Vitoria, Spain.
  • Risco R; Department of Anesthesiology and Critical Care, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, Spain.
  • Parreño-Manchado FC; Department of General Surgery, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain.
  • Gil-Trujillo S; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
  • Benito C; Department of Anaesthesia and Perioperative Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  • Jericó C; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Internal Medicine, Hospital Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Spain.
  • De-Miguel-Cabrera MI; Department of Anaesthesia and Perioperative Medicine, Hospital General Universitari Castelló, Castellón de La Plana, Spain.
  • Ugarte-Sierra B; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of General Surgery, Hospital Galdakao-Usansolo, Spain.
  • Barragán-Serrano C; Department of General Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain.
  • García-Erce JA; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Banco de Sangre y Tejidos de Navarra, Pamplona, Spain.
  • Muñoz-Hernández H; Department of Anaesthesia and Perioperative Medicine, Hospital Clínico de Valladolid, Spain.
  • Río-Fernández SD; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain.
  • Herrero-Bogajo ML; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of General Surgery, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
  • Espinosa-Moreno AM; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, Hospital Universitario Fundación Alcorcón, Alcorcón, Spain.
  • Concepción-Martín V; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of General Surgery, Nuestra Señora de Candelaria Hospital Universitario, Spain.
  • Zorrilla-Vaca A; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Department of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA; Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Harvard
  • Vaquero-Pérez L; Department of Anaesthesia and Perioperative Medicine, Hospital Universitario Río Hortega, Valladolid, Spain.
  • Mojarro I; Department of Anaesthesia and Perioperative Medicine, Juan Ramón Jiménez University Hospital, Huelva, Spain.
  • Llácer-Pérez M; Department of Anaesthesia and Perioperative Medicine, Hospital Costa del Sol, Marbella, Spain.
  • Gómez-Viana L; Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de Ourense, Ourense, Spain.
  • Fernández-Martín MT; Department of Anaesthesia and Perioperative Medicine, Hospital Medina del Campo, Medina del Campo, Spain.
  • Abad-Gurumeta A; Department of Anaesthesia and Perioperative Medicine, Infanta Leonor University Hospital, Madrid, Spain; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Universidad Complutense de Madrid, Madrid, Spain.
  • Ferrando-Ortolà C; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anesthesiology and Critical Care, Hospital Clínic, Institut D'investigació August Pi i Sunyer, Barcelona, Spain; CIBER de Enfermedades Respir
  • Ramírez-Rodríguez JM; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of General Surgery, Lozano Blesa University Hospital, Universidad de Zaragoza, Zaragoza, Spain.
  • Aldecoa C; Spanish Perioperative Audit and Research Network (REDGERM), Zaragoza, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Zaragoza, Spain; Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de Ourense, Ourense, Spain.
Cir Esp (Engl Ed) ; 101(10): 665-677, 2023 Oct.
Article en En | MEDLINE | ID: mdl-37094777
INTRODUCTION: The effectiveness of the Enhanced Recovery After Surgery (ERAS) protocols in gastric cancer surgery remains controversial. METHODS: Multicentre prospective cohort study of adult patients undergoing surgery for gastric cancer. Adherence with 22 individual components of ERAS pathways were assessed in all patients, regardless of whether they were treated in a self-designed ERAS centre. Each centre had a three-month recruitment period between October 2019 and September 2020. The primary outcome was moderate-to-severe postoperative complications within 30 days after surgery. Secondary outcomes were overall postoperative complications, adherence to the ERAS pathway, 30 day-mortality and hospital length of stay (LOS). RESULTS: A total of 743 patients in 72 Spanish hospitals were included, 211 of them (28.4 %) from self-declared ERAS centres. A total of 245 patients (33 %) experienced postoperative complications, graded as moderate-to-severe complications in 172 patients (23.1 %). There were no differences in the incidence of moderate-to-severe complications (22.3% vs. 23.5%; OR, 0.92 (95% CI, 0.59 to 1.41); P = 0.068), or overall postoperative complications between the self-declared ERAS and non-ERAS groups (33.6% vs. 32.7%; OR, 1.05 (95 % CI, 0.70 to 1.56); P = 0.825). The overall rate of adherence to the ERAS pathway was 52% [IQR 45 to 60]. There were no differences in postoperative outcomes between higher (Q1, > 60 %) and lower (Q4, ≤ 45 %) ERAS adherence quartiles. CONCLUSIONS: Neither the partial application of perioperative ERAS measures nor treatment in self-designated ERAS centres improved postoperative outcomes in patients undergoing gastric surgery for cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT03865810.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Recuperación Mejorada Después de la Cirugía Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Cir Esp (Engl Ed) Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: España
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Gástricas / Recuperación Mejorada Después de la Cirugía Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Cir Esp (Engl Ed) Año: 2023 Tipo del documento: Article País de afiliación: España Pais de publicación: España