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Article ; Online: Enhanced Recovery After Surgery (ERAS) in Surgical Oncology.

Ripollés-Melchor, Javier / Abad-Motos, Ane / Zorrilla-Vaca, Andrés

2022 Volume 24, Issue 9, Page(s) 1177–1187

Abstract: Purpose of the review: The objective of this review is to address the rationale behind the application of the Enhanced Recovery After Surgery (ERAS) protocols that could improve oncologic outcomes in adult patients undergoing major surgery.: Recent ... ...

Abstract	Purpose of the review: The objective of this review is to address the rationale behind the application of the Enhanced Recovery After Surgery (ERAS) protocols that could improve oncologic outcomes in adult patients undergoing major surgery. Recent findings: The implementation of ERAS protocols has been associated with fewer postoperative complications as well as decreased return to intended oncologic treatment (RIOT). However, few studies have analyzed the influence of the application of ERAS protocols and long-term oncologic outcomes, although some of its individual elements have been associated with improvements in oncologic outcomes, including overall survival and disease-free survival. Targeted long-term follow-up studies in specific oncologic procedures are required to determine whether ERAS application results in improved oncologic outcomes.
MeSH term(s)	Adult ; Disease-Free Survival ; Enhanced Recovery After Surgery ; Humans ; Length of Stay ; Postoperative Complications ; Surgical Oncology
Language	English
Publishing date	2022-04-11
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057359-5
ISSN	1534-6269 ; 1523-3790
ISSN (online)	1534-6269
ISSN	1523-3790
DOI	10.1007/s11912-022-01282-4
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Article ; Online: Optimizing atrial sensing parameters in leadless pacemakers: Atrioventricular synchrony achievement in the real world.

Briongos-Figuero, Sem / Estévez-Paniagua, Álvaro / Sánchez Hernández, Ana / Jiménez, Silvia / Gómez-Mariscal, Eloy / Abad Motos, Ane / Muñoz-Aguilera, Roberto

Heart rhythm

2022 Volume 19, Issue 12, Page(s) 2011–2018

Abstract: Background: Performance of the leadless pacemaker capable of atrioventricular (AV) synchronous pacing in de novo patients warrants further investigation.: Objective: The aims of this study were to assess what programming changes are needed to achieve ...

Abstract	Background: Performance of the leadless pacemaker capable of atrioventricular (AV) synchronous pacing in de novo patients warrants further investigation. Objective: The aims of this study were to assess what programming changes are needed to achieve proper atrial tracking and to study the percentage of AV synchrony (AVS) the device can provide under real-world conditions. Methods: Consecutive patients undergoing Micra AV implantation between June 2020 and November 2021 were studied. Reprogramming of atrial sensing parameters during follow-up was performed by following device counters. AVS was studied with an ambulatory 24-hour Holter monitor and automatically analyzed by an electrocardiogram delineation system. The primary end point was AVS ≥85% of total cardiac cycles during 24-hour Holter electrocardiogram monitoring. Results: Thirty-one patients who remained in VDD mode were studied, and all of them required manual reprogramming. The automatic A3 window end was deactivated, and a fixed and short value was set in all patients throughout follow-up. AVS significantly increased from 68.7% ± 14.7% at 24-hour follow-up to 83.9% ± 7.4% at 1-month visit (P = .001). At 1-month visit, shorter A3 window end time (P = .019), higher A4 threshold (P = .011), and deactivation of the automatic A3 window (P = .054) were independently related to higher AVS. A total of 2,291,953 Holter-recorded cardiac cycles were analyzed. Median AVS during 24-hour daily activities was 87.6% (interquartile range 84.5%-90.6%). Twenty of 26 patients (79.6%) reached AVS ≥85% of cardiac cycles. Conclusion: High rates of AVS can be achieved in real-world patients undergoing leadless pacing. Manual reprogramming of the atrial sensing parameters is essential to optimize mechanically sensed atrial tracking.
MeSH term(s)	Humans ; Heart Block ; Pacemaker, Artificial ; Heart Atria ; Electrocardiography, Ambulatory ; Electrocardiography ; Cardiac Pacing, Artificial
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2229357-7
ISSN	1556-3871 ; 1547-5271
ISSN (online)	1556-3871
ISSN	1547-5271
DOI	10.1016/j.hrthm.2022.08.007
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Article ; Online: Leadless atrioventricular synchronous pacing: a validation pilot study with Holter monitoring.

Briongos Figuero, Sem / Estévez Paniagua, Álvaro / Sánchez Hernández, Ana / Abad-Motos, Ane / Ruiz, Alicia / Muñoz-Aguilera, Roberto

Revista espanola de cardiologia (English ed.)

2021 Volume 74, Issue 11, Page(s) 992–993

MeSH term(s)	Cardiac Pacing, Artificial ; Electrocardiography, Ambulatory ; Equipment Design ; Humans ; Pacemaker, Artificial ; Pilot Projects
Language	Spanish
Publishing date	2021-06-29
Publishing country	Spain
Document type	Case Reports
ZDB-ID	2592481-3
ISSN	1885-5857 ; 1885-5857
ISSN (online)	1885-5857
ISSN	1885-5857
DOI	10.1016/j.rec.2021.06.004
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Article ; Online: Evaluation and treatment of iron deficiency, with or without anemia, in enhanced recovery after bariatric surgery.

Jericó Alba, Carlos / Abad-Motos, Ane / Ripollés-Melchor, Javier / García-Erce, José Antonio

Cirugia espanola

2019 Volume 98, Issue 1, Page(s) 58–59

Title translation	Evaluación y tratamiento del déficit de hierro con o sin anemia en rehabilitación multimodal de cirugía bariátrica.
MeSH term(s)	Anemia, Iron-Deficiency/complications ; Anemia, Iron-Deficiency/diagnosis ; Anemia, Iron-Deficiency/drug therapy ; Bariatric Surgery ; Humans ; Iron/deficiency ; Iron/therapeutic use ; Obesity, Morbid/complications ; Obesity, Morbid/surgery
Chemical Substances	Iron (E1UOL152H7)
Language	Spanish
Publishing date	2019-10-12
Publishing country	Spain
Document type	Letter
ISSN	2173-5077
ISSN (online)	2173-5077
DOI	10.1016/j.ciresp.2019.08.002
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Article ; Online: Postoperative Critical Care Admission Was Not Associated with Improved Postoperative Outcomes in Elective Colorectal Surgery: Secondary Analysis Of POWER Trial.

Suárez-de-la-Rica, Alejandro / Ripollés-Melchor, Javier / Aldecoa, César / Abad-Motos, Ane / Ferrando, Carlos / Abad-Gurumeta, Alfredo / Díaz-Almirón, Mariana / Gil-Lapetra, Cristina / García-Miguel, Francisco Javier / Pedregosa-Sanz, Ana / Esteve-Pérez, Neus / Rodríguez-Jiménez, Rita / Gimeno Fernandez, Pablo / Maseda, Emilio

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2023 Volume 27, Issue 10, Page(s) 2187–2198

Abstract: Background: The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and ... ...

Abstract	Background: The efficacy of routine admission of high-risk patients to a critical care unit after surgery is not clear. The aim of our study was to investigate the association between critical care admission after scheduled colorectal surgery and postoperative complications, 30-day mortality, and length of stay in hospital. Methods: A pre-defined secondary substudy of POWER study was performed. POWER study was a prospective multicenter observational study of patients undergoing elective primary colorectal surgery during a single period of two months of recruitment between September and December 2017. Results: A total of 2084 patients from 80 Spanish hospitals were included, of which 722 (34.6%) were admitted to critical care unit (CCU) after elective surgery. After adjusting for confounding factors in the multivariate analysis, postoperative CCU admission was independently associated with a higher incidence of moderate-to-severe postoperative complications (adjusted OR 1.951, 95% CI 1.570, 2.425; p < 0.001). Regarding secondary outcomes, postoperative critical care admission was independently associated with higher 30-day mortality (adjusted OR 6.736; 95% CI 2.507, 18.101; p < 0.001) and independently associated with an increased hospital length of stay (adjusted OR 1.143, 95% CI 1.112, 1.175; p < 0.001). Conclusions: Direct admission to CCU after scheduled colorectal surgery was not associated with a reduction in moderate-to-severe postoperative complications.
MeSH term(s)	Humans ; Colorectal Surgery ; Prospective Studies ; Hospitalization ; Critical Care ; Elective Surgical Procedures/adverse effects ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Length of Stay
Language	English
Publishing date	2023-08-07
Publishing country	Netherlands
Document type	Observational Study ; Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-023-05780-z
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Article ; Online: Early Return to Intended Oncologic Therapy after implementation of an Enhanced Recovery After Surgery pathway for gastric cancer surgery.

Garcia-Nebreda, Maria / Zorrilla-Vaca, Andrés / Ripollés-Melchor, Javier / Abad-Motos, Ane / Alvaro Cifuentes, Edurne / Abad-Gurumeta, Alfredo / Mena, Gabriel E / Grant, Michael C / Paseiro-Crespo, Gloria

Langenbeck's archives of surgery

2022 Volume 407, Issue 6, Page(s) 2293–2300

Abstract: Purpose: Time to initiation and completion of adjuvant therapy are critical to improve postoperative oncologic outcomes. This study aims to determine whether an Enhanced Recovery After Surgery (ERAS) pathway for gastric cancer surgery promotes early ... ...

Abstract	Purpose: Time to initiation and completion of adjuvant therapy are critical to improve postoperative oncologic outcomes. This study aims to determine whether an Enhanced Recovery After Surgery (ERAS) pathway for gastric cancer surgery promotes early Return to Intended Oncologic Therapy (RIOT). Methods: This is a before-after intervention study including patients with gastric adenocarcinoma who underwent surgery from January 2016 to January 2021. Two periods were denoted based upon the implementation date of our institutional ERAS pathway (June 2018). Our primary outcome was time to RIOT after surgery. Hodges-Lehmann analysis was used to estimate median differences of non-parametric outcomes. Results: Seventy patients with gastric adenocarcinoma were included (35 in pre-ERAS period and 35 in post-ERAS period). Fourteen of the pre-ERAS and twenty-two patients of the post-ERAS period received adjuvant therapy. Time to RIOT was reduced in the post-ERAS period (median 39 days, IQR 31-49) by 12 days (95% CI 3-14 days, p = 0.01) compared to the pre-ERAS period (median 51 days, IQR 42-62). Length of hospital stay (LOS) was lower in the ERAS group (6 days, IQR 5-11 vs 10 days, IQR 8-13, p < 0.01). Conclusion: Our institutional ERAS pathway for gastric cancer surgery was associated with earlier RIOT and shorter LOS.
MeSH term(s)	Adenocarcinoma/surgery ; Digestive System Surgical Procedures ; Enhanced Recovery After Surgery ; Humans ; Length of Stay ; Postoperative Complications ; Stomach Neoplasms/surgery
Language	English
Publishing date	2022-04-20
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02515-7
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Article ; Online: Patient Characteristics Influencing Adherence to Enhanced Recovery Protocols for Colorectal Surgery: a Multicentric Prospective Study.

Galarza-Prado, Andrés Mauricio / Zorrilla-Vaca, Andres / Healy, Ryan / Ripollés, Javier / Abad-Motos, Ane / Nozal-Mateo, Beatriz / Del Rio, Sabela / Caballero-Lozada, Andrés Fabricio / Stone, Alexander / Mena, Gabriel E / Grant, Michael C

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2022 Volume 26, Issue 4, Page(s) 911–916

Abstract: Background: High compliance within enhanced recovery protocols is associated with lower complication rates. Understanding which clinical characteristics make patients more prone to fail adequate adherence to enhanced recovery after surgery guidelines ... ...

Abstract	Background: High compliance within enhanced recovery protocols is associated with lower complication rates. Understanding which clinical characteristics make patients more prone to fail adequate adherence to enhanced recovery after surgery guidelines are essential to improve quality care. Our aim was to identify patient characteristics that influence adherence to enhanced recovery protocols in colorectal surgery. Methods: A total of 1041 patients underwent colorectal surgery under ERPs from September 2017 through December 2017 across 21 institutions in Spain. Demographic, medical, and surgical characteristics of the patients included were extracted to determine their influence on the adherence to enhanced recovery protocols. High adherence was defined as ≥ 73% (median). A univariate analysis was performed initially, followed by multivariable logistic regression analysis. Results: Over 85% of the patients underwent colorectal surgery for cancer resection, of which 12% had metastatic disease. In multivariable model, the presence of coronary artery disease (aOR 1.79, 95% CI 1.12-2.96, p = 0.045) was significantly associated with high adherence to enhanced recovery protocols, while preoperative hypoalbuminemia (aOR 0.55, 95% CI 0.37-0.82, p = 0.003), indication for ostomy (aOR 0.55, 95% CI 0.4-0.75, p < 0.001), and preoperative transfusion (aOR 0.48, 95% CI 0.26-0.91, p = 0.02) were associated with lower adherence. Conclusion: In this study, patients that had preoperative transfusions, preoperative hypoalbuminemia, and indication for ostomy were more likely to receive care with less adherence to enhanced recovery protocols elements, while patients with coronary artery disease were more likely to receive more enhanced recovery protocols elements during their hospitalization.
MeSH term(s)	Colorectal Surgery ; Coronary Artery Disease/complications ; Guideline Adherence ; Humans ; Hypoalbuminemia/complications ; Length of Stay ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Prospective Studies
Language	English
Publishing date	2022-01-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-021-05234-4
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Article ; Online: Primary Pure Pancreatic -Type Acinar Cell Carcinoma of the Stomach: A Rare Entity with a Difficult Diagnosis and Review of the Literature.

Paseiro-Crespo, Gloria / García-Nebreda, María / Roldán Cortés, David / De la Peña Navarro, Itziar / Álvaro Cifuentes, Edurne / Marqués Medina, Elia / Abad-Motos, Ane

International journal of surgical pathology

2022 Volume 30, Issue 5, Page(s) 528–538

Abstract: Acinar cell carcinoma is an uncommon tumour, representing only 1% to 2% of all exocrine pancreatic tumours. Pancreatic-type acinar cell carcinoma can occur in other organs, including the stomach, but it is extraordinarily rare. We report a case of a 51- ... ...

Abstract	Acinar cell carcinoma is an uncommon tumour, representing only 1% to 2% of all exocrine pancreatic tumours. Pancreatic-type acinar cell carcinoma can occur in other organs, including the stomach, but it is extraordinarily rare. We report a case of a 51-year-old woman with a pancreatic-type pure acinar carcinoma of the stomach coexisting with a large cell B lymphoma synchronously, and a literature review of gastric carcinomas with pancreatic cell differentiation. At present there is a preoperative underdiagnosis of these tumours that could be minimized by including this entity in the differential diagnosis of gastric cancer and by performing immunohistochemical analysis with neuroendocrine markers and exocrine pancreatic enzymes.
MeSH term(s)	Carcinoma, Acinar Cell/diagnosis ; Carcinoma, Acinar Cell/pathology ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Pancreatic Neoplasms/diagnosis ; Pancreatic Neoplasms/pathology ; Stomach Neoplasms/diagnosis ; Stomach Neoplasms/pathology ; Pancreatic Neoplasms
Language	English
Publishing date	2022-01-24
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1336393-1
ISSN	1940-2465 ; 1066-8969
ISSN (online)	1940-2465
ISSN	1066-8969
DOI	10.1177/10668969211065763
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Article ; Online: Intraoperative haemodynamic optimisation using the Hypotension Prediction Index and its impact on tissular perfusion: a protocol for a randomised controlled trial.

Lorente, Juan Victor / Jimenez, Ignacio / Ripollés-Melchor, Javier / Becerra, Alejandra / Wesselink, Wilbert / Reguant, Francesca / Mojarro, Irene / Fuentes, Maria de Los Angeles / Abad-Motos, Ane / Agudelo, Elizabeth / Herrero-Machancoses, Francisco / Callejo, Paula / Bosch, Joan / Monge, Manuel Ignacio

BMJ open

2022 Volume 12, Issue 6, Page(s) e051728

Abstract: Introduction: Intraoperative arterial hypotension is associated with poor postoperative outcomes. The Hypotension Prediction Index (HPI) developed using machine learning techniques, allows the prediction of arterial hypotension analysing the arterial ... ...

Abstract	Introduction: Intraoperative arterial hypotension is associated with poor postoperative outcomes. The Hypotension Prediction Index (HPI) developed using machine learning techniques, allows the prediction of arterial hypotension analysing the arterial pressure waveform. The use of this index may reduce the duration and severity of intraoperative hypotension in adults undergoing non-cardiac surgery. This study aims to determine whether a treatment protocol based on the prevention of arterial hypotension using the HPI algorithm reduces the duration and severity of intraoperative hypotension compared with the recommended goal-directed fluid therapy strategy and may improve tissue oxygenation and organ perfusion. Methods and analysis: We will conduct a multicentre, randomised, controlled trial (N=80) in high-risk surgical patients scheduled for elective major abdominal surgery. All participants will be randomly assigned to a control or intervention group. Haemodynamic management in the control group will be based on standard haemodynamic parameters. Haemodynamic management of patients in the intervention group will be based on functional haemodynamic parameters provided by the HemoSphere platform (Edwards Lifesciences), including dynamic arterial elastance, dP/dt Ethics and dissemination: Ethics committee approval was obtained from the Ethics Committee of Hospital Gregorio Marañón (Meeting of 27 July 2020, minutes 18/2020, Madrid, Spain). Findings will be widely disseminated through peer-reviewed publications and conference presentations. Trial registration number: NCT04301102.
MeSH term(s)	Arterial Pressure ; Elective Surgical Procedures ; Hemodynamics ; Humans ; Hypotension/diagnosis ; Hypotension/etiology ; Hypotension/prevention & control ; Multicenter Studies as Topic ; Perfusion ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2022-06-02
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-051728
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Article ; Online: Association between enrollment in an enhanced recovery program for colorectal cancer surgery and long-term recurrence and survival.

Zorrilla-Vaca, Andres / Ripolles-Melchor, Javier / Abad-Motos, Ane / Mingu, Inés Rubiera / Moreno-Jurado, Nekane / Martínez-Durán, Fátima / Pérez-Martínez, Isabel / Abad-Gurumeta, Alfredo / FuenMayor-Varela, María L / Mena, Gabriel E / Grant, Michael C

Journal of surgical oncology

2022 Volume 125, Issue 8, Page(s) 1269–1276

Abstract: Introduction: Enhanced Recovery After Surgery (ERAS) programs have been shown to minimize the surgical inflammatory response in colorectal cancer. Our objective was to determine the association between an ERAS program for colorectal cancer surgery and ... ...

Abstract	Introduction: Enhanced Recovery After Surgery (ERAS) programs have been shown to minimize the surgical inflammatory response in colorectal cancer. Our objective was to determine the association between an ERAS program for colorectal cancer surgery and oncologic recurrence and survival. Methods: A before-after intervention study was designed, including patients who underwent colorectal cancer surgery between November 2010 and March 2016. Cox hazard regression analysis was performed per cumulative year of follow-up to evaluate the association between ERAS program exposure and overall survival. Subgroup analysis was performed by cancer stage (low [I/II] vs. advanced [III/IV]). Results: In total, 646 patients were included, of which 339 were pre-ERAS and 307 were ERAS. Our overall median compliance rate with ERAS interventions was 90% (interquartile range: 85%-95%). Overall survival rates were higher in the ERAS group within the first 2 years after surgery (89.2% vs. 83.2%; p = 0.04). Multivariable analysis revealed that the ERAS enrollment was associated with a significantly lower risk in 5-year oncologic recurrence (adjusted hazard ratio [aHR]: 0.55; 95% confidence interval [CI]: 0.33-0.94; p = 0.03) and higher 3-year survival (aHR: 0.55; 95% CI: 0.33-0.93; p = 0.03) among patients with advanced cancer stage compared to pre-ERAS counterparts. Conclusions: Patients with advanced colorectal cancer were less likely to suffer oncologic recurrence when managed during the ERAS period.
MeSH term(s)	Colorectal Neoplasms/surgery ; Digestive System Surgical Procedures ; Enhanced Recovery After Surgery ; Humans ; Length of Stay ; Postoperative Complications
Language	English
Publishing date	2022-03-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	82063-5
ISSN	1096-9098 ; 0022-4790
ISSN (online)	1096-9098
ISSN	0022-4790
DOI	10.1002/jso.26836
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