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 .
Clinical characteristics and management of cancer-associated acute venous thromboembolism: findings from the MASTER Registry
MASTER is a multicenter registry of consecutively recruited patients with symptomatic , objective ly confirmed , acute venous thromboembolism . One fifth of the patients enrolled had cancer . In these patients , venous thromboembolism has peculiar features , and its management is more problematic . Background Clinical characteristics and management of acute deep vein thrombosis and pulmonary embolism ( PE ) have been reported to be different in patients with and without cancer . The aim of this paper was to provide information on clinical characteristics and management of acute venous thromboembolism in patients with cancer by means of a large prospect i ve registry . Design and Methods MASTER is a multicenter registry of consecutively recruited patients with symptomatic , objective ly confirmed , acute venous thromboembolism . Information about clinical characteristics and management was collected by an electronic data network at the time of the index event . Results A total of 2119 patients were enrolled , of whom 424 ( 20 % ) had cancer . The incidence of bilateral lower limb deep vein thrombosis was significantly higher in patients with cancer than in patients without cancer ( 8.5 % versus 4.6 % ; p<0.01 ) , as were the rates of iliocaval thombosis ( 22.6 % versus 14 % ; p<0.001 ) , and upper limb deep vein thrombosis ( 9.9 % versus 4.8 % ; p<0.001 ) . Major bleeding ( 3.3 % versus 1.1 % ; p=0.001 ) , in-hospital treatment ( 73.3 % versus 66.6 % ; p=0.02 ) and inferior vena cava filter implantation ( 7.3 % versus 4.1 % ; p=0.005 ) were significantly more frequent in patients with cancer , in whom oral anticoagulants were less often used ( 64.2 % versus 82 % ; p<0.0001 ) . Conclusions The clinical presentation of acute venous thromboembolism is different and often more extensive in cancer patients than in patients free from malignancy . Moreover , the management of the acute phase of venous thromboembolism is more problematic in cancer patients , especially because of a higher rate of major bleeding and the need for implantation of inferior vena cava filters
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 .