Download or read book Generating Evidence for the Perioperative Care of Patients Undergoing Elective Colorectal Surgery written by Katie Elisabeth Rollins and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Transdisciplinary Perioperative Care in Colorectal Surgery written by Kok-Yang Tan and published by Springer. This book was released on 2014-10-07 with total page 269 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of colorectal surgery has undergone tremendous developments in recent decades. Surgery has become less invasive, new perspectives and insights have improved perioperative management and novel outcome measures have been defined. At the same time, the limits of surgical technique and perioperative care are being challenged by more complex patients. In order to realize the immense potential for excellent outcomes in colorectal surgery, coordinated multifaceted care must be delivered within a context of limited resources. Accordingly, there is a pressing need to streamline processes and heighten clinical productivity. Excellent communication and collaboration are required, with constant attention to detail and precision within an environment of learning, research and innovation. This book discusses in depth the transdisciplinary integration of different components of care in colorectal surgery. Pertinent background information on the complexities of current management in colorectal surgery is first provided, followed by discussion of the role of design thinking in care integration. Subsequent chapters focus on a range of issues associated with surgical and perioperative care in patients undergoing colorectal surgery, with emphasis on how the multiple facets of care can be integrated through a transdisciplinary approach. Each chapter provides helpful take-home messages in bullet point form and numerous informative figures and tables are also included. The authors are surgeons, physicians, anesthetists, oncologists, nurses, and allied health professionals with extensive experience in the field.
Download or read book Global Gidelines for the Pevention of Surgical Site Infection written by World Health Organization and published by . This book was released on 2017-01-27 with total page 184 pages. Available in PDF, EPUB and Kindle. Book excerpt: Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US $10 billion per year. No international evidence-based guidelines had previously been available before WHO launched its global guidelines on the prevention of surgical site infection on 3 November 2016, and there are inconsistencies in the interpretation of evidence and recommendations in existing national guidelines. These new WHO guidelines are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
Download or read book Operating Room Leadership and Management written by Alan D. Kaye and published by Cambridge University Press. This book was released on 2012-10-04 with total page 305 pages. Available in PDF, EPUB and Kindle. Book excerpt: Practical resource for all healthcare professionals involved in day-to-day management of operating rooms of all sizes and complexity.
Download or read book Enhanced Recovery After Surgery ERAS Programs for Patients Undergoing Colorectal Surgery written by Nancy L. Greer and published by . This book was released on 2017 with total page 143 pages. Available in PDF, EPUB and Kindle. Book excerpt: Enhanced recovery after surgery (ERAS), also referred to as an enhanced recovery program, fast-track rehabilitation, multimodal management, or similar descriptors, is a multidisciplinary approach to perioperative care. A protocol of components related to preadmission, preoperative, intraoperative, and postoperative care is implemented with the goal of improving patient recovery, facilitating earlier discharge from the hospital, and potentially reducing health care costs without increasing complications or hospital readmissions. The protocol components may contribute to minimizing, and/or improving the response to, physiological stress associated with surgery. Although guidelines for ERAS related to colorectal surgery exist, variation in the number and definition of protocol components contributes to difficulties in determining effectiveness. Little is known about implementation barriers and facilitators as well as components (or combinations of components) key for improved clinical outcomes. In addition, protocol compliance, when reported, may be measured by percentage of elements applied or completed without standardization across elements (timing, regimens, doses, etc). Preliminary literature searches conducted for topic refinement found several systematic reviews on enhanced recovery for colorectal surgery. However, none reported on subgroups based on surgical approach (open or laparoscopic surgery) or colorectal condition. While several noted the enhanced recovery protocol components from the included studies, the standard care protocols were not documented. None commented on barriers or facilitators to implementation of an enhanced recovery program. The defining components of an enhanced recovery program for colorectal surgery have been revised over time and new trials have been published since the search dates of the existing reviews. We provide an updated review of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) looking at comparative effectiveness and harms overall and by type of surgery, colorectal condition, and fidelity to an enhanced recovery protocol. We also review barriers and facilitators to implementation and provide a contextual discussion of compliance and outcomes.
Download or read book Bowel Preparation for Elective Colorectal Procedures written by Sara Khangura and published by . This book was released on 2018 with total page 45 pages. Available in PDF, EPUB and Kindle. Book excerpt: While there is evidence to suggest that mechanical bowel preparation should not be used in isolation, there is renewed interest in determining the value of adding oral antibiotics to the preoperative regimen for elective colorectal procedures. For instance, a recent retrospective database analysis has suggested that there may be an important role for the combination of mechanical bowel preparation and oral antibiotics in reducing postoperative surgical site infections in elective colorectal surgery. Thus, this report aims to review relevant evidence addressing the clinical effectiveness, cost-effectiveness, and evidence-based guidelines for the use of standard, parenteral antibiotic prophylaxis with or without mechanical bowel preparation versus intravenous plus oral antibiotic prophylaxis with or without mechanical bowel preparation for patients undergoing elective colorectal procedures.
Download or read book Surgical Metabolism written by Kimberly A. Davis and published by Springer. This book was released on 2014-07-22 with total page 303 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume is a comprehensive, state-of-the-art review for clinicians with an interest in the peri-operative nutritional management of all surgical patients. The text reviews normal physiology, the pathophysiology of starvation and surgical stressors, and focuses on appropriate nutritional repletion for various common disease states. Specifically, the text addresses the severe metabolic demands created by systemic inflammation, infection, and major insults such as trauma and burns. In addition, the book addresses the growing problem of obesity in surgical populations, including appropriate strategies directed towards the metabolic management of these patients. The text is designed for clinicians across levels of training and provides clear and concise evidence based guidelines for the metabolic management and nutritional support of the surgical patient. Written by experts in the field, Surgical Metabolism: The Metabolic Care of the Surgical Patient is a valuable resource for all clinicians involved in the care of the critically ill.
Download or read book Perioperative Fluid Management written by Ehab Farag and published by Springer Nature. This book was released on 2020-09-28 with total page 582 pages. Available in PDF, EPUB and Kindle. Book excerpt: This revised and expanded second edition presents the most recent evidence-based facts on perioperative fluid management and discusses fluid management from basic sciences to clinical applications and the patients’ outcomes. Recent advances in understanding the Revised Starling principle with new concepts in tissue perfusion and the most recent techniques of perioperative goal directed fluid management are described. The endothelial glycocalyx functions and the influence of fluid management on its integrity are covered in detail; moreover, the techniques for its protection are also discussed. The dilemma of perioperative use of hydroxyethyl starch solutions and the resurgence of interest in using human albumin as an alternative colloid is explored. The problems of using unbuffered solutions during the perioperative period and comparison between restrictive versus liberal fluid management are discussed in full. Lastly, case scenarios for every possible clinical situation describe the most up-to-date fluid management for the corresponding clinical problem. Perioperative Fluid Management, Second Edition is of interest to anesthesiologists and also intensivists.
Download or read book Current Common Dilemmas in Colorectal Surgery written by Christopher M. Schlachta and published by Springer. This book was released on 2018-02-20 with total page 383 pages. Available in PDF, EPUB and Kindle. Book excerpt: This text reviews the areas of colorectal surgery that are at the cutting edge of innovation, paradigm shift and controversy with regard to diagnosis, patient selection, treatment algorithm, and therapeutic approaches. From the impact of enhanced recovery protocols on traditional colorectal practices, to that of novel strategies merging endoscopic and surgical techniques, to recent paradigm shifts in the management of common colorectal disorders, this text provides readers with an update on current controversies and evolving treatment rationale in the management of common colorectal diseases. Current Common Dilemmas in Colorectal Surgery provides a guide for the current common dilemmas that caregivers encounter in their daily practice. It is of great utility to colorectal surgeons, surgical oncologists and general surgeons practicing colorectal surgery, senior residents in general surgery training or surgical oncology or colorectal fellowships, allied healthcare professionals involved in the care of patients with colorectal disease, pharma and biomedical technology industry with an interest in current care of patients with colorectal disease.
Download or read book Enhanced Recovery After Surgery written by Olle Ljungqvist and published by Springer Nature. This book was released on 2020-03-30 with total page 654 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is the first comprehensive, authoritative reference that provides a broad and comprehensive overview of Enhanced Recovery After Surgery (ERAS). Written by experts in the field, chapters analyze elements of care that are both generic and specific to various surgeries. It covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations. Organized into nine parts, this book discusses metabolic responses to surgery, anaesthetic contributions, and optimal fluid management after surgery. Chapters are supplemented with examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge. Enhanced Recovery After Surgery: A Complete Guide to Optimizing Outcomes is an indispensable manual that thoroughly explores common post-operative barriers and challenges.
Download or read book Prehabilitation in Colorectal Cancer Surgery written by Enrico Minnella and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Prehabilitation is a preoperative intervention that aims to prevent or attenuate treatment-related functional decline and its consequences. Given the complex nature of the functional impairment of cancer patients undergoing surgery, our research group has conceptualized prehabilitation as multidisciplinary intervention, including exercise training with both endurance and resistance components, nutritional counseling with protein supplementation, and anxiety reducing strategies. In this thesis, the study population consists in patients undergoing elective colorectal surgery for non-metastatic cancer.Including four original trials and one review article, this dissertation is meant to provide a solid scientific proof in this new and fast growing field. These studies: i) demonstrate that prehabilitation is effective in preventing perioperative functional decline; ii) establish that patients with low physical status, at high-risk for poor surgical outcome, respond to greater extend to prehabilitation; iii) find an association between improved preoperative physical fitness and lower severity of postoperative complications; iv) objectively define functional the trajectory along the whole perioperative period; and v) show that high-intensity interval training is the optimal strategy to improve cardiorespiratory fitness after surgery.Taken together, conclusive evidence is provided that physical functioning could be preserved and optimized during cancer care using prehabilitation, with proven effects in high-risk population, surgical morbidity, and whole-body metabolism. I think is that this scientific finding will foster further research in the topic, and promote the implementation of evidence-based principles into cancer care"--
Download or read book Enhanced Recovery for Major Abdominopelvic Surgery written by Tong Joo Gan and published by . This book was released on 2016-04-11 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Enhanced Recovery for Major Abdominopelvic Surgery is a clinical manual providing detailed, expert guidance on the various components of the enhanced recovery program for major abdominopelvic surgery. Several chapters of the handbook are devoted to overcoming the challenges of implementing an enhanced recovery protocol within a practice or institution. Specific protocols for the most common abdominopelvic surgeries, including colorectal, liver, major gyn, distal pancreas and Whipple¿s, and cystectomy are presented. Evidence supporting the protocol is included in each chapter as appropriate. The handbook is targeted to surgeons, anesthesiologists, nurses, and hospital administrators.
Download or read book Emergency General Surgery written by Carlos V. R. Brown and published by Springer. This book was released on 2018-11-09 with total page 531 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of emergency general surgery encompasses a wide array of surgical diseases, ranging from the simple to the complex. These diseases may include inflammatory, infectious, and hemorrhagic processes spanning the entire gastrointestinal tract. Complications of abdominal wall hernias, compartment syndromes, skin and soft tissue infections, and surgical diseases are significantly complex in special populations, including elderly, obese, pregnant, immunocompromised, and cirrhotic patients. This book covers emergency general surgery topics in a succinct, practical and understandable fashion. After reviewing the general principles in caring for the emergency general surgery patient, this text discusses current evidence and the best practices stratified by organ system, including esophageal, gastroduodenal, hepatobiliary and pancreatic, small and large bowel, anorectal, thoracic, and hernias. Chapters are written by experts in the field and present a logical, straightforward, and easy to understand approach to the emergency general surgery patient, as well as provide patient care algorithms where appropriate. Emergency General Surgery: A Practical Approach provides surgeons and surgery residents with a practical and evidence-based approach to diagnosing and managing a wide array of surgical diseases encountered on emergency general surgery call.
Download or read book The Relationship Between Patient Activation and Surgical Outcomes written by Teodora Dumitra and published by . This book was released on 2019 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Background: Patient activation is a behavioural concept, defined as a patient's knowledge, skills, beliefs and confidence to manage their own health care. In patients with chronic medical conditions, there is a strong association between higher levels of activation and improved healthcare outcomes, higher patient satisfaction, lower rates of health care system utilization and lower costs. However, there is very little evidence investigating the role of patient activation in surgical patients. The purpose of this study was to estimate the extent to which low preoperative activation predicts emergency department (ED) visits, complications, adherence with perioperative care processes and satisfaction after colorectal surgery. Methods: A secondary analysis of data obtained from a randomized trial performed in 2017 at the McGill University Health Center assessing the impact of a mobile health application on adherence with care processes (clinicaltrials.gov identifier NCT03277053) was performed. Participants were adult patients with colonic or rectal diseases who underwent colorectal surgery. The main exposure was patient activation, measured using the Patient Activation Measure (PAM) survey at baseline and before hospital discharge, and classified as high or low. The main outcome was ED visits within 30 days of surgery after hospital discharge. Secondary outcomes were complications, patient satisfaction and adherence to a postoperative colorectal surgery care pathway. Distribution of characteristics was compared between patients with high and low activation using Chi-square or Fisher's exact test and t-test or ANOVA for categorical and continuous variables, respectively. A univariate logistic regression was performed to determine predictors of return to the ED and complications. A multivariate logistic regression including complications, age, gender, comorbidity index and diagnosis was used to estimate the effect of low preoperative activation on return to the ED. Results: A total of 97 patients were included in the study cohort, of which 14% (n=14) had a low baseline level of activation and 86% had high levels of activation. Patient characteristics were similar between the two activation groups. Highly activated patients had higher adherence to postoperative care processes on postoperative day 1 (66% vs 47%, p=0.004), and felt more informed (p=0.000) and more motivated(p=0.004) about their care on the Satisfaction questionnaire. More patients with high activation were discharged within 3 days of surgery compared to low activation patients (37% vs 7%, p=0.021). There was no difference in the percentage of patients with at least one ED visit between the two activation groups (21% in high vs 20% in low group, p=0.548). At hospital discharge, a higher number of patients had low levels of activation compared to preop (30% vs 14% p=0.009). On the univariate logistic regression, the presence of postoperative complications (OR 16.06, 95%CI 3.45-74.72) was the only independent predictors of ED visits. On the multivariate regression, the presence of complications was the only independent predictor of ED visits (OR 19.41, 95%CI 3.84-98.14). Conclusion: This pilot study suggests that levels of activation do not predict of emergency department utilization after discharge in patients undergoing colorectal surgery. However, highly activated patients have a higher adherence to care pathways, tend to be discharged sooner after surgery, and feel more informed and motivated with their care. Furthermore, patient activation levels were decreased in the immediate postoperative period. Further studies in a larger cohort of surgical patients is warranted." --
Download or read book The Changing Role of the Hospital in European Health Systems written by Martin McKee and published by Cambridge University Press. This book was released on 2020-08-13 with total page 327 pages. Available in PDF, EPUB and Kindle. Book excerpt: A team of world-leading policy experts and clinicians analyse the changing role of the hospital across Europe.
Download or read book Laparoscopic Surgery for Colorectal Cancer written by Yoshiharu Sakai and published by Springer. This book was released on 2016-01-25 with total page 243 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides simplified principles of surgical anatomy for colorectal cancers with sophisticated drawings, standard laparoscopic procedures with striking photographs and illustrations, and advanced procedures such as lateral pelvic node dissection and “down to top” or “reverse” total mesorectal excision. Oncological safety as well as minimum invasiveness of laparoscopic surgery for colorectal cancer has been acknowledged worldwide, based on long-term outcomes of several randomized controlled trials comparing laparoscopic surgery and open surgery. Developments in optical devices have provided us with a magnified clear vision of fine anatomical structures, facilitating our understanding of surgical anatomy and surgical procedures have been refined and improved accordingly. All these topics are presented in this book—valuable for surgical residents and experts eager to learn more about laparoscopic colorectal surgery—and readers will be enlightened by a new paradigm for “lap-enhanced surgical anatomy”. Therefore this volume will greatly benefit not only colorectal surgeons but also general surgeons as well as gastroenterologists and oncologists.
Download or read book Anesthesiology A Problem Based Learning Approach written by Tracey Straker and published by Anesthesiology a Problem Based. This book was released on 2018-11-12 with total page 481 pages. Available in PDF, EPUB and Kindle. Book excerpt: Linking existing knowledge to new knowledge by presenting it in the form of a case or a problem is a popular and effective educational approach resulting in better retention of the knowledge and improved ability to apply that knowledge to solve real problems. This problem-based learning (PBL) method was introduced into medical education at McMaster University in Ontario, Canada, in 1969. Since then it has been widely incorporated into secondary, undergraduate, and graduate education in a variety of disciplines worldwide. This new volume for the Anesthesiology Problem-Based Learning series reviews topics in general anesthesiology utilizing the PBL approach. Each chapter deals with conditions and problems in anesthesia practice presented as a case stem with questions to encourage critical thinking, followed by an evidence-based discussion and multiple-choice questions for self-assessment. Current in its knowledge of organ systems and management, the text keeps pace with new technology, new drugs, and new surgical techniques coupled with current guidelines for anesthetic management. Cases highlight the practical issues that arise in the operating room and offers solutions for them. The book can be used to review an upcoming clinical case or as a PBL tool. The Stem Case and Key Questions and Discussion sections can serve as the basis for interactive learning experiences for study groups or as a broad yet in-depth clinical review of the specialty for the individual learner. Self-assessment questions can be used as a measure of knowledge acquisition or simply as a question bank to prepare for examinations.
