PERIOPERATIVE CARE IN DIGESTIVE SURGERY: THE ERAS AND ACERTO PROTOCOLS - BRAZILIAN COLLEGE OF DIGESTIVE SURGERY POSITION PAPER.

Autor:	Aguilar-Nascimento JE; Centro Universitário de Varzea Grande, Department of Surgery - Varzea Grande (MT), Brazil., Ribeiro Junior U; Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology - São Paulo (SP), Brazil., Portari-Filho PE; Universidade Federal do Rio de Janeiro, Faculty of Medicine - Rio de Janeiro (RJ), Brazil., Salomão AB; Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Surgery - São Paulo (SP), Brazil., Caporossi C; Centro Universitário de Varzea Grande, Department of Surgery - Varzea Grande (MT), Brazil., Colleoni Neto R; Universidade Federal de São Paulo, Escola Paulista de Medicina, Department of Surgery - São Paulo (SP), Brazil., Waitzberg DL; Universidade de São Paulo, Faculty of Medicine, Department of Gastroenterology - São Paulo (SP), Brazil., Campos ACL; Universidade Federal do Paraná, Faculty of Medicine, Department of Surgery - Curitiba (PR), Brazil.
Jazyk:	angličtina
Zdroj:	Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery [Arq Bras Cir Dig] 2024 May 06; Vol. 37, pp. e1794. Date of Electronic Publication: 2024 May 06 (Print Publication: 2024).
DOI:	10.1590/0102-672020240001e1794
Abstrakt:	Background: The concept introduced by protocols of enhanced recovery after surgery modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period is of great importance to ensure fewer postoperative complications, reduced length of hospital stay, and decreased surgical costs. Aims: To emphasize the most important points of a multimodal perioperative care protocol. Methods: Careful analysis of each recommendation of both ERAS and ACERTO protocols, justifying their inclusion in the multimodal care recommended for digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is fundamental in digestive surgery, and thus, both preoperative and postoperative nutrition care are key to ensuring fewer postoperative complications and reducing the length of hospital stay. The concept of prehabilitation is another key element in ERPs. The handling of crystalloid fluids in a perfect balance is vital. Fluid overload can delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fasting for two hours before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance the recovery of patients undergoing digestive procedures. Conclusions: This position paper from the Brazilian College of Digestive Surgery strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.
Databáze:	MEDLINE
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