SlideShare uma empresa Scribd logo
1 de 15
Department Colorectal Surgery  ZARAGOZA UNIVERSITY HOSPITAL. SPAIN MULTICENTER NATIONAL STUDY  ON FAST TRACK COLORECTAL SURGERY.  PRELIMINARY RESULTS . JM Ramirez, JA Gracia, P Royo, E Casal-Nuñez, JV Roig, R Cabezali   on behalf of the Spanish working group on fast-track Surgery.
Department Colorectal Surgery (1993) Protocol for Colorectal Cancer   1998 Up-dated (Laparoscopic surgery):  2001 2004 2006 2.006: 141 patients  (Mean age 69 (43-89))
Department Colorectal Surgery (1993) Protocol for Colorectal Cancer   1998 Up-dated (Laparoscopic surgery):  2001 2004 2006 2.006: 141 patients  (Mean age 69 (43-89)) *NBCAP  (21.356 cases) * National Bowel Cancer Audit Project. ACPGBI. Report 2007 10 29,6 4% Length Hospital stay (mean days) Permanent Stoma rate  (PSR) Post-op. Mortality (<30 days) <12  28,3 <5%
[object Object],[object Object],Surgical stress reduction Pain relief Fluid therapy Perioperative surgical care (drains, NGT, Bowel clearance, catheters = Hospital stay Morbidity Mortality
Evidence-Based Surgical Care and the Evolution of Fast-Track Surgery Henrik Kehlet, Douglas W. Wilmore. Ann Surg  2008;248: 189–198
12 Centres Control Group: Retrospective Study (Six months) Prospective Study: Intention to treat Inclusion criteria:  Colorectal cancer Open or Laparocopy Older than 18 y.o. Exclusion criteria: ASA IV Ostomy Previous CRT Madrid, April 2008
According to the Best available evidence we will: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Madrid, April 2008
ON LINE. RECORDING DATA SYSTEM
RESULTS From July 2008 to April 2009
Retrospective Study  182 patients Mean age 69,6 y.o.  ± SD. 13,2 (43-89). Males 61%. 69% 31% Vía abordaje 69% 31% Surgical technique Right colectomy Left Colectomy AR Sigmoidectomy  approach  Open surgery  Lap. Surgery
Overall: 34,82% Retrospective Study Mean Stay: 13 days  ± SD. 13,731 (4-40)  Postoperative morbidity 182 patients Mean age 69,6 y.o.  ± SD. 13,2 (43-89). Males 61%. W. Infection  Bleeding  Death  ileus  anastomotic leak
Early results (135 patients) Prospective Study Mean age 63,4 y.o.  ± SD. 10,2 (38-89). Males 60%. Surgical technique
[object Object],Prospective Study Overall: 32 %
Prospective Retrospect. Laparosc.  Lap.   vs   Open surgery:   63   p.   vs   72 p.   (non stat. Diff.) Results
[object Object],[object Object],[object Object],Summary

Mais conteúdo relacionado

Mais procurados

Neoadjuvant Chemotherapy in muscle invasive bladder cancer: The Standard of ...
Neoadjuvant Chemotherapy in muscle invasive bladder cancer:The Standard of ...Neoadjuvant Chemotherapy in muscle invasive bladder cancer:The Standard of ...
Neoadjuvant Chemotherapy in muscle invasive bladder cancer: The Standard of ...Diaa A. Hameed
 
Debate: CCRT in Pancreatic cancer
Debate: CCRT in Pancreatic cancerDebate: CCRT in Pancreatic cancer
Debate: CCRT in Pancreatic cancerAshutosh Mukherji
 
Pancreatic Cancer
Pancreatic CancerPancreatic Cancer
Pancreatic Cancerspa718
 
Gastric cancer debate adjuvant chemoradiotherapy
Gastric cancer debate  adjuvant chemoradiotherapyGastric cancer debate  adjuvant chemoradiotherapy
Gastric cancer debate adjuvant chemoradiotherapyMohamed Abdulla
 
Managing Locally Advanced Gastric And Ge Junction 2003
Managing Locally Advanced Gastric And Ge Junction 2003Managing Locally Advanced Gastric And Ge Junction 2003
Managing Locally Advanced Gastric And Ge Junction 2003farshad nejad
 
Ca pancreas managment
Ca pancreas managmentCa pancreas managment
Ca pancreas managmentSneha George
 
MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)
MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)
MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)European School of Oncology
 
Rectal cancer debate: Chemoradiation
Rectal cancer debate: ChemoradiationRectal cancer debate: Chemoradiation
Rectal cancer debate: ChemoradiationAshutosh Mukherji
 
Radioactive Iodine Treatment in Thyroid Cancers
Radioactive Iodine Treatment in Thyroid CancersRadioactive Iodine Treatment in Thyroid Cancers
Radioactive Iodine Treatment in Thyroid CancersPradeep Dhanasekaran
 
ECCLU 2011 - N. James - Localised invasive bladder cancer - Radiotherapy
ECCLU 2011 - N. James - Localised invasive bladder cancer - RadiotherapyECCLU 2011 - N. James - Localised invasive bladder cancer - Radiotherapy
ECCLU 2011 - N. James - Localised invasive bladder cancer - RadiotherapyEuropean School of Oncology
 
Rectal dose constraints for salvage iodine-125 prostate brachytherapy.
Rectal dose constraints for salvage iodine-125 prostate brachytherapy.Rectal dose constraints for salvage iodine-125 prostate brachytherapy.
Rectal dose constraints for salvage iodine-125 prostate brachytherapy.Max Peters
 
Muscle invasive bladder carcinoma
Muscle invasive bladder carcinomaMuscle invasive bladder carcinoma
Muscle invasive bladder carcinomaChandana Sanjee
 
Interventional therapy of late onset tracheal stenosis after implantation of ...
Interventional therapy of late onset tracheal stenosis after implantation of ...Interventional therapy of late onset tracheal stenosis after implantation of ...
Interventional therapy of late onset tracheal stenosis after implantation of ...Clinical Surgery Research Communications
 

Mais procurados (20)

Neoadjuvant Chemotherapy in muscle invasive bladder cancer: The Standard of ...
Neoadjuvant Chemotherapy in muscle invasive bladder cancer:The Standard of ...Neoadjuvant Chemotherapy in muscle invasive bladder cancer:The Standard of ...
Neoadjuvant Chemotherapy in muscle invasive bladder cancer: The Standard of ...
 
Debate: CCRT in Pancreatic cancer
Debate: CCRT in Pancreatic cancerDebate: CCRT in Pancreatic cancer
Debate: CCRT in Pancreatic cancer
 
LACE trial
LACE trialLACE trial
LACE trial
 
D'Ugo 2007
D'Ugo 2007D'Ugo 2007
D'Ugo 2007
 
Pancreatic Cancer
Pancreatic CancerPancreatic Cancer
Pancreatic Cancer
 
Gastric cancer debate adjuvant chemoradiotherapy
Gastric cancer debate  adjuvant chemoradiotherapyGastric cancer debate  adjuvant chemoradiotherapy
Gastric cancer debate adjuvant chemoradiotherapy
 
Managing Locally Advanced Gastric And Ge Junction 2003
Managing Locally Advanced Gastric And Ge Junction 2003Managing Locally Advanced Gastric And Ge Junction 2003
Managing Locally Advanced Gastric And Ge Junction 2003
 
Landmark trials in Ovarian Cancer
Landmark trials in Ovarian CancerLandmark trials in Ovarian Cancer
Landmark trials in Ovarian Cancer
 
Ca pancreas managment
Ca pancreas managmentCa pancreas managment
Ca pancreas managment
 
Resection of the prostate
Resection of the prostateResection of the prostate
Resection of the prostate
 
MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)
MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)
MCO 2011 - Slide 23 - P. Rougier - Gastric and pancreatic cancers (part II)
 
Rectal cancer debate: Chemoradiation
Rectal cancer debate: ChemoradiationRectal cancer debate: Chemoradiation
Rectal cancer debate: Chemoradiation
 
Role of surgery in metastatic colorectal cancer
Role of surgery in metastatic colorectal cancerRole of surgery in metastatic colorectal cancer
Role of surgery in metastatic colorectal cancer
 
Radioactive Iodine Treatment in Thyroid Cancers
Radioactive Iodine Treatment in Thyroid CancersRadioactive Iodine Treatment in Thyroid Cancers
Radioactive Iodine Treatment in Thyroid Cancers
 
ECCLU 2011 - N. James - Localised invasive bladder cancer - Radiotherapy
ECCLU 2011 - N. James - Localised invasive bladder cancer - RadiotherapyECCLU 2011 - N. James - Localised invasive bladder cancer - Radiotherapy
ECCLU 2011 - N. James - Localised invasive bladder cancer - Radiotherapy
 
Rectal dose constraints for salvage iodine-125 prostate brachytherapy.
Rectal dose constraints for salvage iodine-125 prostate brachytherapy.Rectal dose constraints for salvage iodine-125 prostate brachytherapy.
Rectal dose constraints for salvage iodine-125 prostate brachytherapy.
 
Muscle invasive bladder carcinoma
Muscle invasive bladder carcinomaMuscle invasive bladder carcinoma
Muscle invasive bladder carcinoma
 
Interventional therapy of late onset tracheal stenosis after implantation of ...
Interventional therapy of late onset tracheal stenosis after implantation of ...Interventional therapy of late onset tracheal stenosis after implantation of ...
Interventional therapy of late onset tracheal stenosis after implantation of ...
 
CARCINOMA CERVIX
CARCINOMA CERVIXCARCINOMA CERVIX
CARCINOMA CERVIX
 
Adjuvant treatment of pancreatic AC
Adjuvant treatment of pancreatic ACAdjuvant treatment of pancreatic AC
Adjuvant treatment of pancreatic AC
 

Semelhante a MULTICENTER NATIONAL STUDY ON FAST TRACK COLORECTAL SURGERY. PRELIMINARY RESULTS.

FT SURGERY IN SPAIN: ON THE WAY TO IMPLEMENTATION?
FT SURGERY IN SPAIN:  ON THE WAY TO IMPLEMENTATION?FT SURGERY IN SPAIN:  ON THE WAY TO IMPLEMENTATION?
FT SURGERY IN SPAIN: ON THE WAY TO IMPLEMENTATION?fast.track
 
Endoscopic submucosal dissection of gastric neoplastic12
Endoscopic submucosal dissection of gastric neoplastic12Endoscopic submucosal dissection of gastric neoplastic12
Endoscopic submucosal dissection of gastric neoplastic12Taisir Shahriar
 
Journal club-Determination of surgical priorities in appendicitis
Journal club-Determination of surgical priorities in appendicitisJournal club-Determination of surgical priorities in appendicitis
Journal club-Determination of surgical priorities in appendicitisYouttam Laudari
 
ECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - Surgery
ECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - SurgeryECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - Surgery
ECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - SurgeryEuropean School of Oncology
 
Can the laparoscopic approach to D2 gastrectomy be justified?
Can the laparoscopic approach to D2 gastrectomy be justified?Can the laparoscopic approach to D2 gastrectomy be justified?
Can the laparoscopic approach to D2 gastrectomy be justified?King Hussien Cancer Center
 
Acutely Obstructing Colorectal Cancer – Treatment Options- Jim Hill
Acutely Obstructing Colorectal Cancer – Treatment Options- Jim HillAcutely Obstructing Colorectal Cancer – Treatment Options- Jim Hill
Acutely Obstructing Colorectal Cancer – Treatment Options- Jim Hilljimmystrein
 
Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...
Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...
Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...Oncocir (Unidad de Oncología Quirúrgica)
 
Minimal Invasive Surgery in Oncology
Minimal Invasive Surgery in OncologyMinimal Invasive Surgery in Oncology
Minimal Invasive Surgery in OncologyPradeep Dhanasekaran
 
Research competition
Research competitionResearch competition
Research competitionImran Javed
 
3DCRT vs IMRT in ca. stomach
3DCRT vs IMRT in ca. stomach3DCRT vs IMRT in ca. stomach
3DCRT vs IMRT in ca. stomachDrAkhileshMishra
 
recent advances in hepatobiliary and GI surgery
recent advances in hepatobiliary and GI surgeryrecent advances in hepatobiliary and GI surgery
recent advances in hepatobiliary and GI surgeryhr77
 
esophageal cancer surgery types and complications
esophageal cancer surgery types and complicationsesophageal cancer surgery types and complications
esophageal cancer surgery types and complicationsved sah
 
113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf
113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf
113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdfKs doctor
 
parsport trial ppt
parsport trial pptparsport trial ppt
parsport trial pptGaurav Kumar
 
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...JohnJulie1
 
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...daranisaha
 

Semelhante a MULTICENTER NATIONAL STUDY ON FAST TRACK COLORECTAL SURGERY. PRELIMINARY RESULTS. (20)

FT SURGERY IN SPAIN: ON THE WAY TO IMPLEMENTATION?
FT SURGERY IN SPAIN:  ON THE WAY TO IMPLEMENTATION?FT SURGERY IN SPAIN:  ON THE WAY TO IMPLEMENTATION?
FT SURGERY IN SPAIN: ON THE WAY TO IMPLEMENTATION?
 
MCC 2011 - Slide 14
MCC 2011 - Slide 14MCC 2011 - Slide 14
MCC 2011 - Slide 14
 
Endoscopic submucosal dissection of gastric neoplastic12
Endoscopic submucosal dissection of gastric neoplastic12Endoscopic submucosal dissection of gastric neoplastic12
Endoscopic submucosal dissection of gastric neoplastic12
 
Journal club-Determination of surgical priorities in appendicitis
Journal club-Determination of surgical priorities in appendicitisJournal club-Determination of surgical priorities in appendicitis
Journal club-Determination of surgical priorities in appendicitis
 
TEP Medline
TEP MedlineTEP Medline
TEP Medline
 
ECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - Surgery
ECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - SurgeryECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - Surgery
ECCLU 2011 - G. Thalmann - Localised invasive bladder cancer - Surgery
 
Can the laparoscopic approach to D2 gastrectomy be justified?
Can the laparoscopic approach to D2 gastrectomy be justified?Can the laparoscopic approach to D2 gastrectomy be justified?
Can the laparoscopic approach to D2 gastrectomy be justified?
 
Acutely Obstructing Colorectal Cancer – Treatment Options- Jim Hill
Acutely Obstructing Colorectal Cancer – Treatment Options- Jim HillAcutely Obstructing Colorectal Cancer – Treatment Options- Jim Hill
Acutely Obstructing Colorectal Cancer – Treatment Options- Jim Hill
 
Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...
Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...
Surgical treatment of hepatocellular carcinoma.(Dr Juan Carlos Meneu Diaz). O...
 
Ulcer peptic
Ulcer pepticUlcer peptic
Ulcer peptic
 
Minimal Invasive Surgery in Oncology
Minimal Invasive Surgery in OncologyMinimal Invasive Surgery in Oncology
Minimal Invasive Surgery in Oncology
 
Research competition
Research competitionResearch competition
Research competition
 
Oesophageal cancer osama
Oesophageal cancer osamaOesophageal cancer osama
Oesophageal cancer osama
 
3DCRT vs IMRT in ca. stomach
3DCRT vs IMRT in ca. stomach3DCRT vs IMRT in ca. stomach
3DCRT vs IMRT in ca. stomach
 
recent advances in hepatobiliary and GI surgery
recent advances in hepatobiliary and GI surgeryrecent advances in hepatobiliary and GI surgery
recent advances in hepatobiliary and GI surgery
 
esophageal cancer surgery types and complications
esophageal cancer surgery types and complicationsesophageal cancer surgery types and complications
esophageal cancer surgery types and complications
 
113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf
113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf
113/02/16-達文西機械手臂手術於耳鼻喉之應用-講師:蘇彥燁主治醫師.pdf
 
parsport trial ppt
parsport trial pptparsport trial ppt
parsport trial ppt
 
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
 
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...
 

Mais de fast.track

ENHANCED RECOVERY AFTER SURGERY (ERAS)
ENHANCED RECOVERY AFTER SURGERY (ERAS)ENHANCED RECOVERY AFTER SURGERY (ERAS)
ENHANCED RECOVERY AFTER SURGERY (ERAS)fast.track
 
Enhanced recovery pathways
Enhanced recovery pathwaysEnhanced recovery pathways
Enhanced recovery pathwaysfast.track
 
Doppler guided intraoperative fluid management evidence base
Doppler guided intraoperative fluid management evidence baseDoppler guided intraoperative fluid management evidence base
Doppler guided intraoperative fluid management evidence basefast.track
 
Doppler Guided Intraoperative Fluid Management Data Analysis
Doppler Guided Intraoperative Fluid Management  Data AnalysisDoppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management Data Analysisfast.track
 
Fast-track Colorectal Surgery in China—3 years’ Experience
Fast-track Colorectal Surgery in China—3 years’ ExperienceFast-track Colorectal Surgery in China—3 years’ Experience
Fast-track Colorectal Surgery in China—3 years’ Experiencefast.track
 
Letter 1 Dr. Paul W. Corey
Letter 1 Dr. Paul W. CoreyLetter 1 Dr. Paul W. Corey
Letter 1 Dr. Paul W. Coreyfast.track
 
Letter 2 Dr. Paul W. Corey
Letter 2 Dr. Paul W. CoreyLetter 2 Dr. Paul W. Corey
Letter 2 Dr. Paul W. Coreyfast.track
 
Preoperative Metabolic Conditioning
Preoperative Metabolic ConditioningPreoperative Metabolic Conditioning
Preoperative Metabolic Conditioningfast.track
 
Preoperative Metabolic Conditioning
Preoperative Metabolic ConditioningPreoperative Metabolic Conditioning
Preoperative Metabolic Conditioningfast.track
 
Haemodynamic Control in Fast-Track Surgery. CardioQ
Haemodynamic Control in Fast-Track Surgery. CardioQHaemodynamic Control in Fast-Track Surgery. CardioQ
Haemodynamic Control in Fast-Track Surgery. CardioQfast.track
 
Simposium Madrid 051108
Simposium Madrid 051108Simposium Madrid 051108
Simposium Madrid 051108fast.track
 
Fluid therapy and colorectal surgery Use or abuse?
Fluid therapy and colorectal surgery  Use or abuse?Fluid therapy and colorectal surgery  Use or abuse?
Fluid therapy and colorectal surgery Use or abuse?fast.track
 
LAparoscopy and/or FAst track multimodal management versus standard care (LAF...
LAparoscopy and/or FAst track multimodal management versus standard care (LAF...LAparoscopy and/or FAst track multimodal management versus standard care (LAF...
LAparoscopy and/or FAst track multimodal management versus standard care (LAF...fast.track
 
Fast-track rehabilitation for elective colonic surgery in Germany
Fast-track  rehabilitation for elective colonic surgery in GermanyFast-track  rehabilitation for elective colonic surgery in Germany
Fast-track rehabilitation for elective colonic surgery in Germanyfast.track
 
Specifieke vragen over het maag-darm systeem
Specifieke vragen over het maag-darm systeemSpecifieke vragen over het maag-darm systeem
Specifieke vragen over het maag-darm systeemfast.track
 
Fast Track Anesthesie Protocol Algemeen
Fast Track Anesthesie Protocol AlgemeenFast Track Anesthesie Protocol Algemeen
Fast Track Anesthesie Protocol Algemeenfast.track
 
Fast Track Rehabilitation For Elective Colonic Surgery In Germany
Fast Track Rehabilitation For Elective Colonic Surgery In GermanyFast Track Rehabilitation For Elective Colonic Surgery In Germany
Fast Track Rehabilitation For Elective Colonic Surgery In Germanyfast.track
 
Perioperative strategy in colonic surgery
Perioperative strategy in colonic surgeryPerioperative strategy in colonic surgery
Perioperative strategy in colonic surgeryfast.track
 
2007 NSW Health Awards Entry
2007 NSW Health Awards Entry2007 NSW Health Awards Entry
2007 NSW Health Awards Entryfast.track
 
Klinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studie
Klinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studieKlinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studie
Klinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studiefast.track
 

Mais de fast.track (20)

ENHANCED RECOVERY AFTER SURGERY (ERAS)
ENHANCED RECOVERY AFTER SURGERY (ERAS)ENHANCED RECOVERY AFTER SURGERY (ERAS)
ENHANCED RECOVERY AFTER SURGERY (ERAS)
 
Enhanced recovery pathways
Enhanced recovery pathwaysEnhanced recovery pathways
Enhanced recovery pathways
 
Doppler guided intraoperative fluid management evidence base
Doppler guided intraoperative fluid management evidence baseDoppler guided intraoperative fluid management evidence base
Doppler guided intraoperative fluid management evidence base
 
Doppler Guided Intraoperative Fluid Management Data Analysis
Doppler Guided Intraoperative Fluid Management  Data AnalysisDoppler Guided Intraoperative Fluid Management  Data Analysis
Doppler Guided Intraoperative Fluid Management Data Analysis
 
Fast-track Colorectal Surgery in China—3 years’ Experience
Fast-track Colorectal Surgery in China—3 years’ ExperienceFast-track Colorectal Surgery in China—3 years’ Experience
Fast-track Colorectal Surgery in China—3 years’ Experience
 
Letter 1 Dr. Paul W. Corey
Letter 1 Dr. Paul W. CoreyLetter 1 Dr. Paul W. Corey
Letter 1 Dr. Paul W. Corey
 
Letter 2 Dr. Paul W. Corey
Letter 2 Dr. Paul W. CoreyLetter 2 Dr. Paul W. Corey
Letter 2 Dr. Paul W. Corey
 
Preoperative Metabolic Conditioning
Preoperative Metabolic ConditioningPreoperative Metabolic Conditioning
Preoperative Metabolic Conditioning
 
Preoperative Metabolic Conditioning
Preoperative Metabolic ConditioningPreoperative Metabolic Conditioning
Preoperative Metabolic Conditioning
 
Haemodynamic Control in Fast-Track Surgery. CardioQ
Haemodynamic Control in Fast-Track Surgery. CardioQHaemodynamic Control in Fast-Track Surgery. CardioQ
Haemodynamic Control in Fast-Track Surgery. CardioQ
 
Simposium Madrid 051108
Simposium Madrid 051108Simposium Madrid 051108
Simposium Madrid 051108
 
Fluid therapy and colorectal surgery Use or abuse?
Fluid therapy and colorectal surgery  Use or abuse?Fluid therapy and colorectal surgery  Use or abuse?
Fluid therapy and colorectal surgery Use or abuse?
 
LAparoscopy and/or FAst track multimodal management versus standard care (LAF...
LAparoscopy and/or FAst track multimodal management versus standard care (LAF...LAparoscopy and/or FAst track multimodal management versus standard care (LAF...
LAparoscopy and/or FAst track multimodal management versus standard care (LAF...
 
Fast-track rehabilitation for elective colonic surgery in Germany
Fast-track  rehabilitation for elective colonic surgery in GermanyFast-track  rehabilitation for elective colonic surgery in Germany
Fast-track rehabilitation for elective colonic surgery in Germany
 
Specifieke vragen over het maag-darm systeem
Specifieke vragen over het maag-darm systeemSpecifieke vragen over het maag-darm systeem
Specifieke vragen over het maag-darm systeem
 
Fast Track Anesthesie Protocol Algemeen
Fast Track Anesthesie Protocol AlgemeenFast Track Anesthesie Protocol Algemeen
Fast Track Anesthesie Protocol Algemeen
 
Fast Track Rehabilitation For Elective Colonic Surgery In Germany
Fast Track Rehabilitation For Elective Colonic Surgery In GermanyFast Track Rehabilitation For Elective Colonic Surgery In Germany
Fast Track Rehabilitation For Elective Colonic Surgery In Germany
 
Perioperative strategy in colonic surgery
Perioperative strategy in colonic surgeryPerioperative strategy in colonic surgery
Perioperative strategy in colonic surgery
 
2007 NSW Health Awards Entry
2007 NSW Health Awards Entry2007 NSW Health Awards Entry
2007 NSW Health Awards Entry
 
Klinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studie
Klinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studieKlinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studie
Klinisch Zorgpad Versneld Herstel Programma Fast Track / LAFA studie
 

Último

Benefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdfBenefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdfLearnyoga
 
Anti viral drug pharmacology classification
Anti viral drug pharmacology classificationAnti viral drug pharmacology classification
Anti viral drug pharmacology classificationNikitaPawar41153
 
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...rightmanforbloodline
 
Drug development life cycle indepth overview.pptx
Drug development life cycle indepth overview.pptxDrug development life cycle indepth overview.pptx
Drug development life cycle indepth overview.pptxMohammadAbuzar19
 
Report Back from SGO: What’s the Latest in Ovarian Cancer?
Report Back from SGO: What’s the Latest in Ovarian Cancer?Report Back from SGO: What’s the Latest in Ovarian Cancer?
Report Back from SGO: What’s the Latest in Ovarian Cancer?bkling
 
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...rightmanforbloodline
 
BURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdfBURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdfDolisha Warbi
 
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxGross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxDr. Rabia Inam Gandapore
 
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptxNegative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptxAdhithya Mullath Ullas
 
High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7
High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7
High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7grandmotherprocess99
 
Face and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxFace and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxDr. Rabia Inam Gandapore
 
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose AcademicsHistology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose AcademicsMedicoseAcademics
 
Signs It’s Time for Physiotherapy Sessions Prioritizing Wellness
Signs It’s Time for Physiotherapy Sessions Prioritizing WellnessSigns It’s Time for Physiotherapy Sessions Prioritizing Wellness
Signs It’s Time for Physiotherapy Sessions Prioritizing WellnessGokuldas Hospital
 
Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024locantocallgirl01
 
Unveiling Alcohol Withdrawal Syndrome: exploring it's hidden depths
Unveiling Alcohol Withdrawal Syndrome: exploring it's hidden depthsUnveiling Alcohol Withdrawal Syndrome: exploring it's hidden depths
Unveiling Alcohol Withdrawal Syndrome: exploring it's hidden depthsYash Garg
 
Treatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas HospitalTreatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas HospitalGokuldas Hospital
 
VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...
VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...
VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...JRRolfNeuqelet
 
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose AcademicsConnective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose AcademicsMedicoseAcademics
 
Forensic medicine MCQ for early learners
Forensic medicine MCQ for early learnersForensic medicine MCQ for early learners
Forensic medicine MCQ for early learnersAlaguPandi5
 
Unit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 QuinolineUnit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 QuinolineAarishRathnam1
 

Último (20)

Benefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdfBenefits of Chanting Hanuman Chalisa .pdf
Benefits of Chanting Hanuman Chalisa .pdf
 
Anti viral drug pharmacology classification
Anti viral drug pharmacology classificationAnti viral drug pharmacology classification
Anti viral drug pharmacology classification
 
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
TEST BANK For Porth's Essentials of Pathophysiology, 5th Edition by Tommie L ...
 
Drug development life cycle indepth overview.pptx
Drug development life cycle indepth overview.pptxDrug development life cycle indepth overview.pptx
Drug development life cycle indepth overview.pptx
 
Report Back from SGO: What’s the Latest in Ovarian Cancer?
Report Back from SGO: What’s the Latest in Ovarian Cancer?Report Back from SGO: What’s the Latest in Ovarian Cancer?
Report Back from SGO: What’s the Latest in Ovarian Cancer?
 
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
TEST BANK For Nursing Leadership, Management, and Professional Practice for t...
 
BURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdfBURNS (CLASSIFICATION & MANAGEMENTS).pdf
BURNS (CLASSIFICATION & MANAGEMENTS).pdf
 
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxGross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
 
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptxNegative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
Negative Pressure Wound Therapy in Diabetic Foot Ulcer.pptx
 
High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7
High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7
High Purity 99% PMK Ethyl Glycidate Powder CAS 28578-16-7
 
Face and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxFace and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptx
 
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose AcademicsHistology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
Histology of Epithelium - Dr Muhammad Ali Rabbani - Medicose Academics
 
Signs It’s Time for Physiotherapy Sessions Prioritizing Wellness
Signs It’s Time for Physiotherapy Sessions Prioritizing WellnessSigns It’s Time for Physiotherapy Sessions Prioritizing Wellness
Signs It’s Time for Physiotherapy Sessions Prioritizing Wellness
 
Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024Top 10 Most Beautiful Russian Pornstars List 2024
Top 10 Most Beautiful Russian Pornstars List 2024
 
Unveiling Alcohol Withdrawal Syndrome: exploring it's hidden depths
Unveiling Alcohol Withdrawal Syndrome: exploring it's hidden depthsUnveiling Alcohol Withdrawal Syndrome: exploring it's hidden depths
Unveiling Alcohol Withdrawal Syndrome: exploring it's hidden depths
 
Treatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas HospitalTreatment Choices for Slip Disc at Gokuldas Hospital
Treatment Choices for Slip Disc at Gokuldas Hospital
 
VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...
VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...
VIII.1 Nursing Interventions to Promote Healthy Psychological responses, SELF...
 
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose AcademicsConnective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
Connective Tissue II - Dr Muhammad Ali Rabbani - Medicose Academics
 
Forensic medicine MCQ for early learners
Forensic medicine MCQ for early learnersForensic medicine MCQ for early learners
Forensic medicine MCQ for early learners
 
Unit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 QuinolineUnit 4 Pharmaceutical Organic Chemisty 3 Quinoline
Unit 4 Pharmaceutical Organic Chemisty 3 Quinoline
 

MULTICENTER NATIONAL STUDY ON FAST TRACK COLORECTAL SURGERY. PRELIMINARY RESULTS.

  • 1. Department Colorectal Surgery ZARAGOZA UNIVERSITY HOSPITAL. SPAIN MULTICENTER NATIONAL STUDY ON FAST TRACK COLORECTAL SURGERY. PRELIMINARY RESULTS . JM Ramirez, JA Gracia, P Royo, E Casal-Nuñez, JV Roig, R Cabezali   on behalf of the Spanish working group on fast-track Surgery.
  • 2. Department Colorectal Surgery (1993) Protocol for Colorectal Cancer 1998 Up-dated (Laparoscopic surgery): 2001 2004 2006 2.006: 141 patients (Mean age 69 (43-89))
  • 3. Department Colorectal Surgery (1993) Protocol for Colorectal Cancer 1998 Up-dated (Laparoscopic surgery): 2001 2004 2006 2.006: 141 patients (Mean age 69 (43-89)) *NBCAP (21.356 cases) * National Bowel Cancer Audit Project. ACPGBI. Report 2007 10 29,6 4% Length Hospital stay (mean days) Permanent Stoma rate (PSR) Post-op. Mortality (<30 days) <12 28,3 <5%
  • 4.
  • 5. Evidence-Based Surgical Care and the Evolution of Fast-Track Surgery Henrik Kehlet, Douglas W. Wilmore. Ann Surg 2008;248: 189–198
  • 6. 12 Centres Control Group: Retrospective Study (Six months) Prospective Study: Intention to treat Inclusion criteria: Colorectal cancer Open or Laparocopy Older than 18 y.o. Exclusion criteria: ASA IV Ostomy Previous CRT Madrid, April 2008
  • 7.
  • 8. ON LINE. RECORDING DATA SYSTEM
  • 9. RESULTS From July 2008 to April 2009
  • 10. Retrospective Study 182 patients Mean age 69,6 y.o. ± SD. 13,2 (43-89). Males 61%. 69% 31% Vía abordaje 69% 31% Surgical technique Right colectomy Left Colectomy AR Sigmoidectomy approach Open surgery Lap. Surgery
  • 11. Overall: 34,82% Retrospective Study Mean Stay: 13 days ± SD. 13,731 (4-40) Postoperative morbidity 182 patients Mean age 69,6 y.o. ± SD. 13,2 (43-89). Males 61%. W. Infection Bleeding Death ileus anastomotic leak
  • 12. Early results (135 patients) Prospective Study Mean age 63,4 y.o. ± SD. 10,2 (38-89). Males 60%. Surgical technique
  • 13.
  • 14. Prospective Retrospect. Laparosc. Lap. vs Open surgery: 63 p. vs 72 p. (non stat. Diff.) Results
  • 15.