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Guidelines on enhanced recovery after pulmonary lobectomy
Pascal Berna1, Christophe Quesnel2, Jalal Assouad3
1Department of Thoracic Surgery, Amiens University Hospital, 80000 Amiens, France.
This study establishes 32 expert recommendations for optimizing pulmonary lobectomy patient care, focusing on Enhanced Recovery After Surgery (ERAS) protocols. The guidelines aim to improve perioperative management through evidence-based practices and strong consensus.
Area of Science:
- Thoracic Surgery
- Anesthesiology
- Critical Care Medicine
Background:
- Pulmonary lobectomy requires optimized perioperative management.
- Enhanced Recovery After Surgery (ERAS) protocols are crucial for patient recovery.
- Expert consensus is needed to standardize best practices.
Framework:
- A consensus committee of 13 experts from SFAR and SFCTCV was convened.
- Recommendations were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.
- Five domains were addressed: patient pathway, preoperative management, anesthesia, surgical strategy, and ERAS.
Implementation:
- An extensive literature search and PICO-based questions guided the process.
- Recommendations were formulated and voted on using the GRADE grid method.
- 32 recommendations were established with strong or moderate consensus.
Implications:
- The guidelines provide a strong consensus for optimizing the entire perioperative management of pulmonary lobectomy patients.
- Evidence-based recommendations aim to improve patient outcomes and recovery.
- Standardized protocols can enhance the effectiveness of ERAS in thoracic surgery.
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