Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced recovery after surgery (ERAS®) Society Recommendations — Part I: Preoperative and intraoperative management
| Autor: | Ahmed Al-Niaimi, Alon D. Altman, Marc Pocard, Lloyd A. Mack, Mohammad Alyami, Delia Cortes Guiral, Pompiliu Piso, S.P. Somashekhar, Martin Hübner, Olivia Sgarbura, Anupama Wadhwa, Laura A. Lambert, Laurent Villeneuve, Robert E. Bristow, William Fawcett, Konstantin Balonov, John Bell, Anna Fagotti, Olivier Glehen, Shigeki Kusamura, Beate Rau, Tino Muenster, Jula Veerapong, Gregg Nelson, Luiz Fernando dos Reis Falcão |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Delphi Technique Delphi method Hyperthermic Intraperitoneal Chemotherapy Guidelines Perioperative Care Preoperative Care medicine Humans Cytoreductive surgery Enhanced recovery after surgery Enhanced recovery Peritoneal Neoplasms Intraoperative Care HIPEC business.industry General surgery Cytoreduction Surgical Procedures General Medicine Gynaecological surgery Settore MED/40 - GINECOLOGIA E OSTETRICIA Oncology Intraoperative management Perioperative care Surgery Hyperthermic intraperitoneal chemotherapy Fresh frozen plasma Enhanced Recovery After Surgery business |
| Zdroj: | European Journal of Surgical Oncology. 46:2292-2310 |
| ISSN: | 0748-7983 |
| Popis: | Background Enhanced recovery after surgery (ERAS) pathways have been shown to considerably reduce complications, length of stay and costs after most of surgical procedures by standardised application of best evidence-based perioperative care. The aim was to elaborate dedicated recommendations for cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC) in a two-part series of guidelines based on expert consensus. The present part I of the guidelines highlights preoperative and intraoperative management. Methods The core group assembled a multidisciplinary panel of 24 experts involved in peritoneal surface malignancy surgery representing the fields of general surgery (n = 12), gynaecological surgery (n = 6), and anaesthesia (n = 6). Experts systematically reviewed and summarized the available evidence on 72 identified perioperative care items, following the GRADE (grading of recommendations, assessment, development, evaluation) system. Final consensus (defined as ≥50%, or ≥70% of weak/strong recommendations combined) was reached by a standardised 2-round Delphi process, regarding the strength of recommendations. Results Response rates were 100% for both Delphi rounds. Quality of evidence was evaluated high, moderate low and very low, for 15 (21%), 26 (36%), 29 (40%) and 2 items, respectively. Consensus was reached for 71/72(98.6%) items. Strong recommendations were defined for 37 items, No consensus could be reached regarding the preemptive use of fresh frozen plasma. Conclusion The present ERAS recommendations for CRS±HIPEC are based on a standardised expert consensus process providing clinicians with valuable guidance. There is an urgent need to produce high quality studies for CRS±HIPEC and to prospectively evaluate recommendations in clinical practice. |
| Databáze: | OpenAIRE |
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