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Enhanced Recovery After Surgery (ERAS) Protocol for Abdominal Wall Reconstruction. A Scoping Review of Items Included
Andrea Balla1,2, Ahmad Jaber3, Salvador Morales-Conde1,2
1Department of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, Sevilla, Spain.
Enhanced Recovery After Surgery (ERAS) protocols for abdominal wall reconstruction (AWR) show significant variability and heterogeneity in their components. Further research is needed to establish optimal ERAS protocols for AWR patients.
Area of Science:
- Surgical innovation and patient recovery protocols.
- Multidisciplinary approach to surgical patient management.
- Evidence-based medicine and systematic reviews.
Background:
- Enhanced Recovery After Surgery (ERAS) protocols are increasingly utilized in various surgical fields.
- Abdominal wall reconstruction (AWR) involves complex surgical procedures requiring optimized postoperative care.
- Existing ERAS protocols for AWR exhibit considerable variability and heterogeneity in their specific components.
Purpose of the Study:
- To systematically review and report the diverse items employed within ERAS protocols for patients undergoing abdominal wall reconstruction (AWR).
- To identify and categorize the components of ERAS protocols used in AWR to understand current practices.
- To highlight the heterogeneity and variability in ERAS protocol implementation for AWR.
Main Methods:
- A systematic scoping review was conducted following PRISMA guidelines and registered with PROSPERO.
- Searches were performed across major databases: PubMed, Embase, and Web of Science.
- Twelve articles were included after a thorough screening process, focusing on ERAS protocol items rather than clinical outcomes.
Main Results:
- A total of 140 distinct ERAS items were identified and categorized across multiple domains.
- Key categories included preoperative counseling, nutrition optimization, thromboprophylaxis, nausea management, fluid balance, normothermia, drain management, analgesia, early mobilization, and intestinal recovery.
- Significant variability and heterogeneity were observed in the specific items and categories across different ERAS protocols for AWR.
Conclusions:
- This scoping review offers a comprehensive overview of current ERAS protocol components in AWR.
- The heterogeneity in protocol design and limited evidence quality preclude strong item-specific recommendations.
- Further high-quality research, including randomized trials and registry data, is essential to define optimal ERAS protocols for AWR patients.
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