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Contemporary perioperative care strategies
M Adamina1, O Gié, N Demartines
1Department of Surgery, Kantonsspital St Gallen, St Gallen, Switzerland; Institute for Surgical Research and Hospital Management, University of Basel, Basel, Switzerland. michel.adamina@gmail.com
The British Journal of Surgery
|November 21, 2012
Summary
Multidisciplinary perioperative care significantly improves outcomes for gastrointestinal cancer patients. Key interventions include accelerated recovery pathways and prophylactic measures, enhancing surgical oncology results.
Area of Science:
- Surgical Oncology
- Multidisciplinary Care
Background:
- Historically, surgeons solely managed preoperative and postoperative care for gastrointestinal cancer patients.
- Contemporary perioperative care is a multidisciplinary effort impacting cancer-specific outcomes.
Purpose of the Study:
- To review perioperative interventions that enhance outcomes in surgical oncology.
- To identify key elements of modern perioperative care.
Main Methods:
- Literature review of PubMed and Cochrane Library (1966-2012).
- Included randomized controlled trials, prospective series, systematic reviews, and meta-analyses.
- Keywords: fast-track, enhanced recovery, accelerated rehabilitation, multimodal, perioperative care.
Main Results:
- Accelerated recovery pathways, thromboembolism/antibiotic prophylaxis, hyperoxygenation, normothermia, and laparoscopic surgery improve patient recovery and outcomes.
- Cautious use of non-steroidal anti-inflammatory drugs and chlorhexidine-alcohol skin preparation are important.
- Multidisciplinary meetings are crucial for multimodal therapy determination.
Conclusions:
- Multidisciplinary management of perioperative patient care has demonstrably improved outcomes in surgical oncology.
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