Evidence‐based review of enhancing postoperative recovery after breast surgery
Identifieur interne : 002167 ( Istex/Corpus ); précédent : 002166; suivant : 002168Evidence‐based review of enhancing postoperative recovery after breast surgery
Auteurs : R. Arsalani-Zadeh ; D. Elfadl ; N. Yassin ; J. MacfieSource :
- British Journal of Surgery [ 0007-1323 ] ; 2011-02.
Abstract
The introduction of enhanced recovery after surgery (ERAS) protocols has revolutionized preoperative and postoperative care. To date, however, the principles of enhanced recovery have not been applied specifically to patients undergoing breast surgery.
Url:
DOI: 10.1002/bjs.7331
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ISTEX:495B18023CC64760D75D4BC96EF8CB8A04D96D5FLe document en format XML
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Background:
<p>The introduction of enhanced recovery after surgery (ERAS) protocols has revolutionized preoperative and postoperative care. To date, however, the principles of enhanced recovery have not been applied specifically to patients undergoing breast surgery.</p>
Methods:
<p>Based on the core features of ERAS, individual aspects of postoperative care in breast surgery were defined. A comprehensive search of MEDLINE, PubMed, Embase and the Cochrane Library database was performed from 1980 to 2010 to determine the best evidence for perioperative care in oncological breast surgery. A graded recommendation based on the best level of evidence was then proposed for each feature of ERAS.</p>
Results:
<p>Twelve core features of enhanced recovery after breast surgery were identified. Use of the thoracic block, from both analgesic and anaesthetic viewpoints, is well supported by evidence and should be encouraged. Trials specific to breast surgery regarding aspects such as perioperative fasting, preanaesthetic medication, prevention of hypothermia and postdischarge support are scarce, and evidence was extrapolated from non‐breast trials. Trials on postoperative analgesia and prevention of postoperative nausea and vomiting in breast surgery are generally of small numbers. In addition, there is heterogeneity between studies.</p>
Conclusion:
<p>This review suggests that the principles of enhanced recovery can be adopted in breast surgery. A 12‐point protocol is proposed for prospective evaluation. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</p></abstract><abstract xml:lang="en" style="short"><p>Fast‐track protocol for breast surgery</p></abstract><textClass><classCode scheme="articleCategory">Review</classCode><classCode scheme="tocHeading1">Reviews</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/495B18023CC64760D75D4BC96EF8CB8A04D96D5F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>John Wiley & Sons, Ltd.</publisherName><publisherLoc>Chichester, UK</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1365-2168</doi><issn type="print">0007-1323</issn><issn type="electronic">1365-2168</issn><idGroup><id type="product" value="BJS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="BRITISH JOURNAL OF SURGERY">British Journal of Surgery</title><title type="short">Br J Surg</title></titleGroup></publicationMeta><publicationMeta level="part" position="20"><doi origin="wiley" registered="yes">10.1002/bjs.v98.2</doi><numberingGroup><numbering type="journalVolume" number="98">98</numbering><numbering type="journalIssue">2</numbering></numberingGroup><coverDate startDate="2011-02">February 2011</coverDate></publicationMeta><publicationMeta level="unit" type="reviewArticle" position="50" status="forIssue"><doi origin="wiley" registered="yes">10.1002/bjs.7331</doi><idGroup><id type="unit" value="BJS7331"></id></idGroup><countGroup><count type="pageTotal" number="16"></count></countGroup><titleGroup><title type="articleCategory">Review</title><title type="tocHeading1">Reviews</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 British Journal of Surgery Society Ltd. 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To date, however, the principles of enhanced recovery have not been applied specifically to patients undergoing breast surgery.</p></section><section xml:id="abs1-2"><title type="main">Methods:</title><p>Based on the core features of ERAS, individual aspects of postoperative care in breast surgery were defined. A comprehensive search of MEDLINE, PubMed, Embase and the Cochrane Library database was performed from 1980 to 2010 to determine the best evidence for perioperative care in oncological breast surgery. A graded recommendation based on the best level of evidence was then proposed for each feature of ERAS.</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>Twelve core features of enhanced recovery after breast surgery were identified. Use of the thoracic block, from both analgesic and anaesthetic viewpoints, is well supported by evidence and should be encouraged. Trials specific to breast surgery regarding aspects such as perioperative fasting, preanaesthetic medication, prevention of hypothermia and postdischarge support are scarce, and evidence was extrapolated from non‐breast trials. Trials on postoperative analgesia and prevention of postoperative nausea and vomiting in breast surgery are generally of small numbers. In addition, there is heterogeneity between studies.</p></section><section xml:id="abs1-4"><title type="main">Conclusion:</title><p>This review suggests that the principles of enhanced recovery can be adopted in breast surgery. A 12‐point protocol is proposed for prospective evaluation. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</p></section></abstract><abstract type="short" xml:lang="en"><p>Fast‐track protocol for breast surgery</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Evidence‐based review of enhancing postoperative recovery after breast surgery</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Postoperative recovery after breast surgery</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Evidence‐based review of enhancing postoperative recovery after breast surgery</title></titleInfo><name type="personal"><namePart type="given">R.</namePart><namePart type="family">Arsalani‐Zadeh</namePart><affiliation>Postgraduate Medical Institute, University of Hull, Hull HU6 7RX, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D.</namePart><namePart type="family">ELFadl</namePart><affiliation>Postgraduate Medical Institute, University of Hull, Hull HU6 7RX, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">N.</namePart><namePart type="family">Yassin</namePart><affiliation>Postgraduate Medical Institute, University of Hull, Hull HU6 7RX, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">J.</namePart><namePart type="family">MacFie</namePart><affiliation>Postgraduate Medical Institute, University of Hull, Hull HU6 7RX, UK</affiliation><affiliation>Postgraduate Medical Institute, University of Hull, Hull HU6 7RX, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle"></genre><originInfo><publisher>John Wiley & Sons, Ltd.</publisher><place><placeTerm type="text">Chichester, UK</placeTerm></place><dateIssued encoding="w3cdtf">2011-02</dateIssued><dateValid encoding="w3cdtf">2010-09-17</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">6</extent><extent unit="references">125</extent></physicalDescription><abstract>The introduction of enhanced recovery after surgery (ERAS) protocols has revolutionized preoperative and postoperative care. To date, however, the principles of enhanced recovery have not been applied specifically to patients undergoing breast surgery.</abstract><abstract>Based on the core features of ERAS, individual aspects of postoperative care in breast surgery were defined. A comprehensive search of MEDLINE, PubMed, Embase and the Cochrane Library database was performed from 1980 to 2010 to determine the best evidence for perioperative care in oncological breast surgery. A graded recommendation based on the best level of evidence was then proposed for each feature of ERAS.</abstract><abstract>Twelve core features of enhanced recovery after breast surgery were identified. Use of the thoracic block, from both analgesic and anaesthetic viewpoints, is well supported by evidence and should be encouraged. Trials specific to breast surgery regarding aspects such as perioperative fasting, preanaesthetic medication, prevention of hypothermia and postdischarge support are scarce, and evidence was extrapolated from non‐breast trials. Trials on postoperative analgesia and prevention of postoperative nausea and vomiting in breast surgery are generally of small numbers. In addition, there is heterogeneity between studies.</abstract><abstract>This review suggests that the principles of enhanced recovery can be adopted in breast surgery. A 12‐point protocol is proposed for prospective evaluation. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</abstract><abstract type="short" lang="en">Fast‐track protocol for breast surgery</abstract><relatedItem type="host"><titleInfo><title>British Journal of Surgery</title></titleInfo><titleInfo type="abbreviated"><title>Br J Surg</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Review</topic></subject><identifier type="ISSN">0007-1323</identifier><identifier type="eISSN">1365-2168</identifier><identifier type="DOI">10.1002/(ISSN)1365-2168</identifier><identifier type="PublisherID">BJS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>98</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>181</start><end>196</end><total>16</total></extent></part></relatedItem><identifier type="istex">495B18023CC64760D75D4BC96EF8CB8A04D96D5F</identifier><identifier type="DOI">10.1002/bjs.7331</identifier><identifier type="ArticleID">BJS7331</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 British Journal of Surgery Society Ltd. 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