The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
Reproducibility and normal ranges for gastric emptying in normal volunteers using a test meal designed for post-operative patients†
Scintigraphy is the current gold st and ard for the quantification of gastric emptying ; however , results vary with meal composition . We modified a dual phase meal for administration to patients in the early post-operative period and aim ed to test the reproducibility of the method , to obtain normal ranges and to compare these with previous data . Twenty healthy volunteers ( 10 male , 10 female ) , studied prospect ively , were compared with 10 historical male volunteers . Each volunteer was studied twice ( Test 1 at day 0 and Test 2 at day 7 - 10 ) . After an overnight fast , subjects had Meal A consisting of a 60 g pancake labelled with 3 MBq of non-absorbable 99mTc-ion exchange resin and 100 ml of water labelled with 0.5 MBq of non-absorbable 111In-diethylenetriamine pentaacetic acid ( 111In-DTPA ) . Anterior and posterior gamma camera images of the stomach were obtained every 20 min for 3 h. The time for 50 % emptying ( T50 ) was derived from time-activity curves . Data obtained for males were compared with historical data using a similar technique with Meal B , consisting of two pancakes and a 200 ml milkshake labelled with identical amounts of radioisotopes . The mean ( 95 % CI ) T50 values for solid phase emptying for males and females using Meal A , and for historical males using Meal B , were 51.1 min ( 44.1 - 58.1 ) , 58.6 min ( 52.7 - 64.5 ) and 128.9 min ( 112.8 - 145.1 ) , respectively . Corresponding figures for the liquid phase were 33.2 min ( 26.1 - 40.3 ) , 50.2 min ( 38.4 - 62.1 ) and 30.7 min ( 21.4 - 39.9 ) . Bl and -Altman plots for each phase showed good agreement between Tests 1 and 2 for Meal A. The modified test meal gave reproducible results in healthy volunteers ; however , solid phase emptying was significantly faster than that of the bulkier test meal in historical subjects
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .