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Publications (10 of 241) Show all publications
McQueen, K., Oodit, R., Derbew, M., Banguti, P. & Ljungqvist, O. (2018). Authors' Reply: Enhanced Recovery After Surgery for Low and Middle-Income Countries [Letter to the editor]. World Journal of Surgery
Open this publication in new window or tab >>Authors' Reply: Enhanced Recovery After Surgery for Low and Middle-Income Countries
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2018 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323Article in journal, Letter (Refereed) Epub ahead of print
Place, publisher, year, edition, pages
Taylor & Francis, 2018
National Category
Social Sciences Interdisciplinary
Identifiers
urn:nbn:se:oru:diva-67024 (URN)10.1007/s00268-018-4652-4 (DOI)29717348 (PubMedID)
Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-05-18Bibliographically approved
Oodit, R. L., Ljungqvist, O. & Moodley, J. (2018). Can an Enhanced Recovery After Surgery (ERAS) programme improve colorectal cancer outcomes in South Africa?. South African Journal of Wurgery, 56(1), 8-11
Open this publication in new window or tab >>Can an Enhanced Recovery After Surgery (ERAS) programme improve colorectal cancer outcomes in South Africa?
2018 (English)In: South African Journal of Wurgery, ISSN 0038-2361, E-ISSN 2078-5151, Vol. 56, no 1, p. 8-11Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
South African Medical Association, 2018
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-68339 (URN)10.17159/2078-5151/2018/v56n1a2320 (DOI)000439026800002 ()29638086 (PubMedID)2-s2.0-85045381998 (Scopus ID)
Available from: 2018-08-02 Created: 2018-08-02 Last updated: 2018-09-14Bibliographically approved
Francis, N. K., Walker, T., Carter, F., Hübner, M., Balfour, A., Jakobsen, D. H., . . . Ljungqvist, O. (2018). Consensus on Training and Implementation of Enhanced Recovery After Surgery: A Delphi Study. World Journal of Surgery, 42(7), 1919-1928
Open this publication in new window or tab >>Consensus on Training and Implementation of Enhanced Recovery After Surgery: A Delphi Study
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2018 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 42, no 7, p. 1919-1928Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Enhanced Recovery After Surgery (ERAS) is widely accepted in current surgical practice due to its positive impact on patient outcomes. The successful implementation of ERAS is challenging and compliance with protocols varies widely. Continual staff education is essential for successful ERAS programmes. Teaching modalities exist, but there remains no agreement regarding the optimal training curriculum or how its effectiveness is assessed. We aimed to draw consensus from an expert panel regarding the successful training and implementation of ERAS.

METHODS: A modified Delphi technique was used; three rounds of questionnaires were sent to 58 selected international experts from 11 countries across multiple ERAS specialities and multidisciplinary teams (MDT) between January 2016 and February 2017. We interrogated opinion regarding four topics: (1) the components of a training curriculum and the structure of training courses; (2) the optimal framework for successful implementation and audit of ERAS including a guide for data collection; (3) a framework to assess the effectiveness of training; (4) criteria to define ERAS training centres of excellence.

RESULTS: An ERAS training course must cover the evidence-based principles of ERAS with team-oriented training. Successful implementation requires strong leadership, an ERAS facilitator and an effective MDT. Effectiveness of training can be measured by improved compliance. A training centre of excellence should show a willingness to teach and demonstrable team working.

CONCLUSIONS: We propose an international expert consensus providing an ERAS training curriculum, a framework for successful implementation, methods for assessing effectiveness of training and a definition of ERAS training centres of excellence.

Place, publisher, year, edition, pages
Springer, 2018
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Surgery
Identifiers
urn:nbn:se:oru:diva-64040 (URN)10.1007/s00268-017-4436-2 (DOI)000434470100002 ()29302724 (PubMedID)2-s2.0-85040090064 (Scopus ID)
Available from: 2018-01-12 Created: 2018-01-12 Last updated: 2018-09-12Bibliographically approved
Blixt, C., Ahlstedt, C., Ljungqvist, O., Isaksson, B., Kalman, S. & Rooyackers, O. (2018). Corrigendum to ‘The effect of perioperative glucose control on postoperative insulin resistance’ [Clin Nutr 31 (5) (2012) 676–681]. Clinical Nutrition, 37(3), 1091-1091
Open this publication in new window or tab >>Corrigendum to ‘The effect of perioperative glucose control on postoperative insulin resistance’ [Clin Nutr 31 (5) (2012) 676–681]
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2018 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 37, no 3, p. 1091-1091Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2018
National Category
Nutrition and Dietetics
Identifiers
urn:nbn:se:oru:diva-67204 (URN)10.1016/j.clnu.2018.03.007 (DOI)000432879800054 ()29599083 (PubMedID)2-s2.0-85044278044 (Scopus ID)
Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2018-08-30Bibliographically approved
Ahl, R., Matthiessen, P., Fang, X., Cao, Y., Sjölin, G., Lindgren, R., . . . Mohseni, S. (2018). Effect of beta-blocker therapy on early mortality after emergency colonic cancer surgery. British Journal of Surgery
Open this publication in new window or tab >>Effect of beta-blocker therapy on early mortality after emergency colonic cancer surgery
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2018 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Emergency colorectal cancer surgery is associated with significant mortality. Induced adrenergic hyperactivity is thought to be an important contributor. Downregulating the effects of circulating catecholamines may reduce the risk of adverse outcomes. This study assessed whether regular preoperative beta-blockade reduced mortality after emergency colonic cancer surgery.

METHODS: This cohort study used the prospectively collected Swedish Colorectal Cancer Registry to recruit all adult patients requiring emergency colonic cancer surgery between 2011 and 2016. Patients were subdivided into those receiving regular beta-blocker therapy before surgery and those who were not (control). Demographics and clinical outcomes were compared. Risk factors for 30-day mortality were evaluated using Poisson regression analysis.

RESULTS: A total of 3187 patients were included, of whom 685 (21·5 per cent) used regular beta-blocker therapy before surgery. The overall 30-day mortality rate was significantly reduced in the beta-blocker group compared with controls: 3·1 (95 per cent c.i. 1·9 to 4·7) versus 8·6 (7·6 to 9·8) per cent respectively (P < 0·001). Beta-blocker therapy was the only modifiable protective factor identified in multivariable analysis of 30-day all-cause mortality (incidence rate ratio 0·31, 95 per cent c.i. 0·20 to 0·47; P < 0·001) and was associated with a significant reduction in death of cardiovascular, respiratory, sepsis and multiple organ failure origin.

CONCLUSION: Preoperative beta-blocker therapy may be associated with a reduction in 30-day mortality following emergency colonic cancer surgery.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Surgery Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-69119 (URN)10.1002/bjs.10988 (DOI)30259967 (PubMedID)
Available from: 2018-10-01 Created: 2018-10-01 Last updated: 2018-10-02Bibliographically approved
McQueen, K., Oodit, R., Derbew, M., Banguti, P. & Ljungqvist, O. (2018). Enhanced Recovery After Surgery for Low- and Middle-Income Countries. World Journal of Surgery, 42(4), 950-952
Open this publication in new window or tab >>Enhanced Recovery After Surgery for Low- and Middle-Income Countries
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2018 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323, Vol. 42, no 4, p. 950-952Article in journal, Editorial material (Refereed) Published
Place, publisher, year, edition, pages
Springer, 2018
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-64847 (URN)10.1007/s00268-018-4481-5 (DOI)000427050900006 ()29383424 (PubMedID)2-s2.0-85041176141 (Scopus ID)
Available from: 2018-02-07 Created: 2018-02-07 Last updated: 2018-04-03Bibliographically approved
Ljungqvist, O. & Hubner, M. (2018). Enhanced recovery after surgery-ERAS-principles, practice and feasibility in the elderly. Aging Clinical and Experimental Research, 30(3), 249-252
Open this publication in new window or tab >>Enhanced recovery after surgery-ERAS-principles, practice and feasibility in the elderly
2018 (English)In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 30, no 3, p. 249-252Article, review/survey (Refereed) Published
Abstract [en]

This is a short overview of the principles of a novel development in surgery called enhanced recovery after surgery (ERAS) programs. This is an evidence-based approach to perioperative care that has shown to reduce complications and recovery time by 30-50%. The main mechanism is reduction of the stress reactions to the operation. These principles have been shown to be particularly well suited for the compromised patient and hence very good for the elderly people who often have co-morbidities and run a higher risk of complications.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
Surgery; Stress; Recovery; Elderly
National Category
Geriatrics
Identifiers
urn:nbn:se:oru:diva-65196 (URN)10.1007/s40520-018-0905-1 (DOI)000427751600006 ()29453605 (PubMedID)
Note

Funding Agency:

Nyckelfonden, Örebro, Sweden

Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-08-20Bibliographically approved
Frauche, P., Hübner, M. & Ljungqvist, O. (2018). Fast-track and ERAS programs i Geriatric Surgery (1ed.). In: G. Bettelli (Ed.), Perioperative Care of the Elderly: Clinical and Organizational Aspects (pp. 226-232). Cambridge, United Kingdom: Cambridge University Press
Open this publication in new window or tab >>Fast-track and ERAS programs i Geriatric Surgery
2018 (English)In: Perioperative Care of the Elderly: Clinical and Organizational Aspects / [ed] G. Bettelli, Cambridge, United Kingdom: Cambridge University Press, 2018, 1, p. 226-232Chapter in book (Refereed)
Place, publisher, year, edition, pages
Cambridge, United Kingdom: Cambridge University Press, 2018 Edition: 1
National Category
Medical and Health Sciences Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-64365 (URN)978-1-107-13934-3 (ISBN)
Available from: 2018-01-17 Created: 2018-01-17 Last updated: 2018-02-21Bibliographically approved
Batchelor, T. J. P., Rasburn, N. J., Abdelnour-Berchtold, E., Brunelli, A., Cerfolio, R. J., Gonzalez, M., . . . Naidu, B. (2018). Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS). European Journal of Cardio-Thoracic Surgery
Open this publication in new window or tab >>Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS®) Society and the European Society of Thoracic Surgeons (ESTS)
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2018 (English)In: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734XArticle in journal (Refereed) Epub ahead of print
Abstract [en]

Enhanced recovery after surgery is well established in specialties such as colorectal surgery. It is achieved through the introduction of multiple evidence-based perioperative measures that aim to diminish postoperative organ dysfunction while facilitating recovery. This review aims to present consensus recommendations for the optimal perioperative management of patients undergoing thoracic surgery (principally lung resection). A systematic review of meta-analyses, randomized controlled trials, large non-randomized studies and reviews was conducted for each protocol element. Smaller prospective and retrospective cohort studies were considered only when higher-level evidence was unavailable. The quality of the evidence base was graded by the authors and used to form consensus recommendations for each topic. Development of these recommendations was endorsed by the Enhanced Recovery after Surgery Society and the European Society for Thoracic Surgery. Recommendations were developed for a total of 45 enhanced recovery items covering topics related to preadmission, admission, intraoperative care and postoperative care. Most are based on good-quality studies. In some instances, good-quality data were not available, and subsequent recommendations are generic or based on data extrapolated from other specialties. In other cases, no recommendation can currently be made because either equipoise exists or there is a lack of available evidence. Recommendations are based not only on the quality of the evidence but also on the balance between desirable and undesirable effects. Key recommendations include preoperative counselling, nutritional screening, smoking cessation, prehabilitation for high-risk patients, avoidance of fasting, carbohydrate loading, avoidance of preoperative sedatives, venous thromboembolism prophylaxis, prevention of hypothermia, short-acting anaesthetics to facilitate early emergence, regional anaesthesia, nausea and vomiting control, opioid-sparing analgesia, euvolemic fluid management, minimally invasive surgery, early chest drain removal, avoidance of urinary catheters and early mobilization after surgery. These guidelines outline recommendations for the perioperative management of patients undergoing lung surgery based on the best available evidence. As the recommendation grade for most of the elements is strong, the use of a systematic perioperative care pathway has the potential to improve outcomes after surgery.

Place, publisher, year, edition, pages
Springer, 2018
National Category
Surgery Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-69583 (URN)10.1093/ejcts/ezy301 (DOI)30304509 (PubMedID)
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2018-10-19Bibliographically approved
Gustafsson, U. O., Scott, M. J., Hubner, M., Nygren, J., Demartines, N., Francis, N., . . . Ljungqvist, O. (2018). Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018. World Journal of Surgery
Open this publication in new window or tab >>Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations: 2018
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2018 (English)In: World Journal of Surgery, ISSN 0364-2313, E-ISSN 1432-2323Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background: This is the fourth updated Enhanced Recovery After Surgery (ERAS®) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol.

Methods: A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system.

Results: All recommendations on ERAS® protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly.

Conclusions: The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS® Society in this comprehensive consensus review.

Place, publisher, year, edition, pages
Springer, 2018
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Surgery
Identifiers
urn:nbn:se:oru:diva-70174 (URN)10.1007/s00268-018-4844-y (DOI)30426190 (PubMedID)
Available from: 2018-11-15 Created: 2018-11-15 Last updated: 2018-11-16Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0003-2636-4745

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