ERAS in Mexico

Last August 11th, 2018 we received at the National Cancer Institute, Mexico, Dr. Adrián Álvarez and Nurse Gabriela Sánchez from Hospital Italiano de Buenos Aires. The objective was to start our training to implement ERAS in our Digestive Tract Tumors Department.  We counted with the presence of the Associate Medical General Director of our Institution, Dr. Ángel Herrera Gómez, and Vice-Director of Surgery, Dr. Aarón González Enciso.

For the implementation of this program we created a team in each area that this program will be implemented, the Colorectal team, coordinated by the Head of the Department, Dr. Horacio López Basave and the Pancreatic surgery team coordinated by Dr. Javier Melchor Ruan.  With a total of 20 attendants the training started in the morning discussing the goals of the ERAS program and stating which is the necessary process for its implementation. Doubts about how to manage changes in the perioperative process of the patient were clarified and each team set its short- term goals. We had the first contact with EIAS system and we defined activities for the first two months.

With great enthusiasm we started our training counting with the active presence of Nurse Mariana Perales; authorities of the Nurse Department of the Institution as well as representatives of the Anesthesia and Nutrition Departments, associate physicians and residents.

Dr. Javier Melchor Ruan- ERAS INCAN Program Coordinator

Top Row – left to right: Crisenry Brito Baños- Anesthesiologist, Luis Cuellar- Head of Anesthesia Department, Abraham Fabela- Anesthesiologist, Luis Orozco Rosas- Surgery resident, Maura Judith Tomas- Anesthesiologist, Sergio Aguilar- Oncologic Surgery resident, Gerardo Miranda: Pancreatic Associate surgeon, Aarón González Enciso: Surgery Vice Director, Javier Melchor : ERAS Program Coordinator, Itzel Vela Sarmiento: Associate Colorectal Surgeon, Mariana Perales: ERAS Program Nurse Coordinator, María Josefina, Flores: Nutritionist, Anabel Labana – Nutritionist, Alberto León : Associate Colorectal Surgeon
Bottom row – left to right: Emma Ávila García: Surgery Nurse Supervisor, Inés Mendoza Santos: Head Nurse, National Cancer Institute, Horacio López Basave: Head of Digestive Tract Tumor Department, Adrián Álvarez, Juan Manuel Ruiz: Surgical Coordinator, Erika Gonzalez Soriano: Surgery Head Nurse

 

 

 

 

 

The Reporting on ERAS Compliance, Outcomes, and Elements Research (RECOvER) Checklist: A Joint Statement by the ERAS® and ERAS® USA Societies

NEW PUBLICATION ALERT!

Click here to access this new publication produced by members of the ERAS Society.

 

Elias KM, Stone AB, McGinigle K, Tankou JI, Scott MJ, Fawcett WJ, Demartines N, Lobo DN, Ljungqvist O, UrmanRD; ERAS® Society  and ERAS® USA (2018) The Reporting on ERAS Compliance, Outcomes, and Elements Research (RECOvER) Checklist: A Joint Statement by the ERAS® and ERAS® USA Societies. World J Surg. 2018 Aug 16. doi: 10.1007/s00268-018-4753-0. 

“The RECOvER Checklist is intended to provide a standardized framework for the reporting of ERAS related studies. The checklist can also assist reviewers in evaluating the quality of ERAS-related manuscripts. Authors are encouraged to include the RECOvER Checklist when submitting ERAS-related studies to peer-reviewed journals.”

8th ERAS UK Conference, 16th November 2018, Heathrow Airport, London, UK.

This year ERAS UK are arranging this conference in partnership with Macmillan Cancer Support and will be focussing on the optimisation of treatment and recovery, throughout a cancer patient’s journey.

 

 

 

At the end of this event, participants should be able to:

  • Describe the impact of prehabilitation on the treatment of cancer patients
  • Discuss the new developments in anaesthesia and perioperative care for cancer patients
  • Explain the innovative approaches used for prehabilitation in primary care
  • Debate the challenges for prehabilitation of cancer patients within the regulated waiting times
  • Consider the recent innovations in ERAS practice across the UK
  • Describe the current best practice for optimising patient condition through palliative chemotherapy
  • Reflect on the various models of prehabilitation that exist at different centres in the UK
  • Explain the links between prehabilitation and cancer commissioning priorities

For all the details on programme, speakers, and how to register, click here

1st World Congress on Enhanced Recovery After Surgery in Pediatrics

The 1st World Congress on Enhanced Recovery After Surgery in Pediatrics, will be held on November 30 – December 1, 2018, at the McGlothlin Medical Education Center, 1200 East Marshall Street, Richmond, Virginia, United States of America.

This inaugural event will bring together experts in surgery, anesthesia and medicine to discuss the pediatric-specific implications of developing an enhanced recovery after surgery program. A full one and a half days are devoted to lectures and discussions related to current pediatric ERAS programs and will provide a platform for collaboration on future projects related to ERAS outcomes around the world.

Click here to download the full programme and details of how to register

Podcast – What’s the relationship between Enhanced Recovery after Surgery (ERAS) and Prehabilitation?

In this podcast, Prof Mike Grocott, interviews guests;

Olle Ljungqvist, Prof. of Surgery, MD, PhD, Surgeon, Örebro University Hospital & Karolinska Institute, Sweden

Franco Carli, Prof. MD, PhD, Anesthesiologist, McGill University, Canada.

They discuss the relationship between Enhanced Recovery after Surgery (ERAS) and Prehabilitation, and their highlights of the recent prehabilitation conference in Eindhoven.

Click here

World Journal of Surgery is now the official publication of the ERAS Society

The ERAS Society is delighted to announce that the World Journal of Surgery (WJS) has become the official journal for society.  This new relationship, and the mission of the ERAS Society very much fits the mission of the WJS, which is to promote innovation and discovery that helps to improve patient outcomes on the international stage.

Sosa, J.A. & Ljungqvist, O. World J Surg (2018).

Professor Kenneth Fearon Memorial Cancer Cachexia Symposium

On the 6-7th September 2018, the Professor Kenneth Fearon Memorial Cancer Cachexia Symposium will be held at Edinburgh University. As well as being a pioneer in the field of ERAS, Prof Fearon was as a leading light in the field of cancer cachexia, with over 170 peer-reviewed publications focused on the topic.

For more details on the symposium click here

New delphi study from ERAS experts – a consensus on training and implementation of ERAS

Congratulations to Prof Nader Francis and colleagues on their recently published Delphi study looking to provide a consensus on training and implementation of Enhanced Recovery After Surgery. Effective ERAS training courses must cover the evidence-based principles of ERAS with team-oriented training, and successful implementation of ERAS requires strong leadership, an ERAS facilitator and an effective MDT.

Click here to read the full article in the World Journal of Surgery.

Report on the 6th ERAS® World Congress

The 6th ERAS® Society World Congress was held at the Clarion Sign Hotel, Stockholm, Sweden, from the 23rd – 25th May 2018.  Enjoying beautiful spring sunshine, the Congress was our most successful to date. The international standing of the Society was confirmed attracting 585 delegates worldwide. Whilst the majority came from Europe (73%), over 11% of delegates came from both North America and Asia, with smaller numbers from Oceania (2%), South America (2%), and Africa (<1%). Locally we had very strong support, attracting 137 Swedish delegates.

 

This was easily the best attended Congress to date with a nearly 50% increase in numbers from Lyon in 2017 (393) and Lisbon in 2016 (389). We also surpassed the numbers in Washington in 2015 (492) – which was a combined meeting with EBPOM and ASER. These delegate numbers reflect the growing worldwide interest for ERAS®. We also had 13 abstracts selected for oral presentation and 102 poster presentations (all published in Clinical Nutrition ESPEN 2018;25:166-209 with a link to the abstracts here).

 

On 23rd May, there was the ever-popular ERAS® course where delegates learnt about the relevant pathophysiology and perspectives from different healthcare professionals – surgeons, anaesthesiologists and nursing.  In addition, clinical audit and speciality-specific areas were covered. There were also a number of other symposia – cardiac surgery, women’s health/gynecology, urology, nursing and AHP meeting during this first afternoon. A major highlight of the day was the official joining of ERAS® Cardiac Surgery to the ERAS® Society.

 

The Scientific Programme began on 24th May and following addresses by both the ERAS® Chairman,  Professor Olle Ljungqvist and Professor Anders Thorell (Congress Chairman), new frontiers were discussed. A highlight was The Ken Fearon lecture, delivered by Professor Luca Gianotti, from Monza, entitled “Critical aspects of clinical trials in surgery and ERAS”.

 

The majority of this day focussed on new ERAS® frontiers (thoracic surgery, emergency laparotomy, pediatric surgery and cardiac surgery), perioperative anaemia, the challenging ERAS patient (diabetes, mobilisation with paraplegia, dementia and substance abuse) and the difficult problem of postoperative ileus also discussed. A popular session was the interactive discussion about complex cases. The day ended with presentations of the best six abstracts.

 

The final day’s highlight was The Henrik Kehlet lecture, delivered by Professor Pierre-Alain Clavien from Zurich, entitled “New concept of benchmarking in surgery”, tracing the evolution of Clavien-Dindo classification into the Comprehensive Complication Index (CCI).  Other sessions included experts discussing epidurals versus wound catheters, delayed gastric emptying, bowel preparation, and barriers to the adoption of ERAS® worldwide. One area that has received little attention to date is what to do with the ERAS® patient after discharge from hospital? An entire session was devoted to this with presentations on nutrition, thromboprophylaxis, exercise training and structured nursing follow-up. The concepts of ERAS® and survival – both long and short term – and patient partnership were also discussed. Seven excellent rapid-fire presentations were also delivered.

 

The congress ended with presentation of the best paper prize to:

 

THE EFFECTS OF BETA-BLOCKER THERAPY ON EARLY MORTALITY FOLLOWING EMERGENCY COLON CANCER SURGERY 

Rebecka Ahl 1, Peter Matthiessen 1, 2, Xin Fang 3, Yang Cao 1, 3, Gabriel Sjölin 1, 2, Rickard Lindgren 2, Olle Ljungqvist 1, 4, Shahin Mohseni 1, 2

1 School of Medical Sciences, Örebro University, 2 Department of Surgery, Örebro University Hospital, Örebro, 3 Institute of Environmental Medicine, 4 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

 

And the best rapid fire presentation to:

 

RISK FACTORS FOR DELAYED GASTRIC EMPTYING AFTER PANCREATICODUODENECTOMY AND NEED FOR ENTERAL FEEDING ACCESS IN THE ERAS® ERA

William B. Lyman 1, Michael Passeri 2, Russell C. Kirks 1, Allyson Cochran 2, John B. Martinie 2, Dionisios Vrochides 2, Erin H. Baker 2, David A. Iannitti 2.

1 Department of Surgery, Carolinas Medical Center, Charlotte, United States; 2 Division of HPB Surgery, Carolinas Medical Center, Charlotte, United States

 

What were the highlights? The two keynote lectures were, as always, enthralling. The wealth of excellent research is always heartening as superb worldwide talent is taking ERAS® forward. The satellite symposia? The ERAS® Course? The many excellent lectures? The joining of ERAS® Cardiac Society?

 

Full details of the Congress and our sponsors can be found here. Also, follow us on twitter @ErasSociety, we have increased our followers to nearly 1700! We had very good twitter activity with over 175 individuals sending over 800 tweets and using #ERAS2018, in all reaching nearly a quarter of a million people! Finally keep an eye for interviews and photos from the Congress which will be posted on the website the coming months.

 

We offer our sincere thanks to all involved in the delivery of an outstanding meeting, in particular the Congress President Anders Thorell and his local organising Committee, the speciality group chairs and the ERAS® executive committee. In addition many thanks go to our sponsors and our excellent congress planners, MCI Suisse.

 

Already we are planning the 7th ERAS® Society World Congress which will be held at the Liverpool Arena and Convention Centre (ACC),UK, May 1-3, 2019. Please make a note of the date and we very much look forward to welcoming you and your teams there!

 

Dr WJ Fawcett

June 2018