Evidence map›Paper›PMID 27231517›Full record

ArticleWorld journal of gastrointestinal surgery2016

Enhanced recovery program is safe and improves postoperative insulin resistance in gastrectomy.

Nobuaki Fujikuni, Kazuaki Tanabe, Noriaki Tokumoto, Takahisa Suzuki, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of gastrointestinal surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Nobuaki FujikuniNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Kazuaki TanabeNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Noriaki TokumotoNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Takahisa SuzukiNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Minoru HattoriNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Toshihiro MisumiNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Hideki OhdanNobuaki Fujikuni, Kazuaki Tanabe, Minoru Hattori, Toshihiro Misumi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Hiroshima University, Hiroshima 734-8551, Japan.
Hiroshima Prefectural Hospital · JPCreative Research Enterprises (United States) · USHiroshima University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo assess the safety of enhanced recovery after surgery (ERAS) program in gastrectomy and influences on nutrition state and insulin-resistance.

methodsOur ERAS program involved shortening the fasting periods and preoperative carbohydrate loading. Eighty gastrectomy patients were randomly assigned to either the conventional group (CG) or ERAS group (EG). We assessed the clinical characteristics and postoperative outcomes prospectively. The primary endpoint was noninferiority in timely discharge from the hospital within 12 d. Secondary endpoints were the incidence of aspiration at anesthesia induction, incidence of postoperative complications, health related quality of life (HRQOL) using the SF8 Health Survey questionnaire, nutrition state [e.g., albumin, transthyretin (TTR), retinal-binding protein (RBP), and transferrin (Tf)], the homeostasis model assessment-insulin resistance (HOMA-R) index, postoperative urine volume, postoperative weight change, and postoperative oral intake.

resultsThe ERAS program was noninferior to the conventional program in achieving discharge from the hospital within 12 d (95.0% vs 92.5% respectively; 95%CI: -10.0%-16.0%). There was no significant difference in postoperative morbidity between the two groups. Adverse events such as vomiting and aspiration associated with the induction of general anesthesia were not observed. There were no significant differences with respect to postoperative urine volume, weight change, and oral intake between the two groups. EG patients with preoperative HOMA-R scores above 2.5 experienced significant attenuation of their HOMA-R scores on postoperative day 1 compared to CG patients (P = 0.014). There were no significant differences with respect to rapid turnover proteins (TTR, RBP and Tf) or HRQOL scores using the SF8 method.

conclusionApplying the ERAS program to patients who undergo gastrectomy is safe, and improves insulin resistance with no deterioration in QOL.

Indexed as

Carbon hydrogen oxygenEnhanced recovery after surgeryGastrectomyInsulin resistanceRandomized controlled trial

Identifiers

PMID27231517
PMCPMC4872067
OpenAlexW2400919436

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.