食管切除术
医学
心胸外科
血管外科
指南
普通外科
食管癌
围手术期
审计
心脏外科
多学科方法
重症监护医学
梅德林
腹部外科
外科
癌症
内科学
社会科学
管理
病理
社会学
政治学
法学
经济
作者
Donald E. Low,William Allum,Giovanni De Manzoni,Lorenzo Ferri,Arul Immanuel,MadhanKumar Kuppusamy,Simon Law,Mats Lindblad,Nick Maynard,Joseph M. Neal,C.S. Pramesh,Mike Scott,B. Mark Smithers,Valérie Addor,Olle Ljungqvist
标识
DOI:10.1007/s00268-018-4786-4
摘要
Abstract Introduction Enhanced recovery after surgery (ERAS) programs provide a format for multidisciplinary care and has been shown to predictably improve short term outcomes associated with surgical procedures. Esophagectomy has historically been associated with significant levels of morbidity and mortality and as a result routine application and audit of ERAS guidelines specifically designed for esophageal resection has significant potential to improve outcomes associated with this complex procedure. Methods A team of international experts in the surgical management of esophageal cancer was assembled and the existing literature was identified and reviewed prior to the production of the guidelines. Well established procedure specific components of ERAS were reviewed and updated with changes relevant to esophagectomy. Procedure specific, operative and technical sections were produced utilizing the best current level of evidence. All sections were rated regarding the level of evidence and overall recommendation according to the evaluation (GRADE) system. Results Thirty‐nine sections were ultimately produced and assessed for quality of evidence and recommendations. Some sections were completely new to ERAS programs due to the fact that esophagectomy is the first guideline with a thoracic component to the procedure. Conclusions The current ERAS society guidelines should be reviewed and applied in all centers looking to improve outcomes and quality associated with esophageal resection.
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