Evidence map›Paper›PMID 34312719›Full record

Observational studyLangenbeck's archives of surgery2021

Improving postoperative outcome in rectal cancer surgery: Enhanced Recovery After Surgery in an era of increasing laparoscopic resection.

Nathalie Bakker, Hiëronymus J Doodeman, Michalda S Dunker, Wilhelmina H Schreurs, Alexander P J Houdijk

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Langenbeck's archives of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 27% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Review
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

5 authors at 2 institutions in 1 country.

Nathalie BakkerNorthwest Clinics, Department of Surgery, NWZ Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands.
Hiëronymus J DoodemanNorthwest Clinics, Department of Surgery, NWZ Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands.
Michalda S DunkerNorthwest Clinics, Department of Surgery, NWZ Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands.
Wilhelmina H SchreursNorthwest Clinics, Department of Surgery, NWZ Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands.
Alexander P J HoudijkNorthwest Clinics, Department of Surgery, NWZ Alkmaar, Wilhelminalaan 12, 1815 JD, Alkmaar, the Netherlands. a.p.j.houdijk@nwz.nl.
Amsterdam University Medical Centers · NLVrije Universiteit Amsterdam · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Enhanced Recovery After Surgery (ERAS) protocol reduces complications and length of stay (LOS) in colon cancer, but implementation in rectal cancer is different because of neo-adjuvant therapy and surgical differences. Laparoscopic resection may further improve outcome. The aim of this study was to evaluate the effects of introducing ERAS on postoperative outcome after rectal cancer resection in an era of increasing laparoscopic resections. MATERIALS AND

methodsPatients who underwent elective rectal cancer surgery from 2009 till 2015 were included in this observational cohort study. In 2010, ERAS was introduced and adherence to the protocol was registered. Open and laparoscopic resections were compared. With regression analysis, predictive factors for postoperative outcome and LOS were identified.

resultsA total of 499 patients were included. The LOS decreased from 12.3 days in 2009 to 5.7 days in 2015 (p = 0.000). Surgical site infections were reduced from 24% in 2009 to 5% in 2015 (p = 0.013) and postoperative ileus from 39% in 2009 to 6% in 2015 (p = 0.000). Only postoperative ERAS items and laparoscopic surgery were associated with an improved postoperative outcome and shorter LOS.

conclusionsERAS proved to be feasible, safe, and contributed to improving short-term outcome in rectal cancer resections. The benefits of laparoscopic surgery may in part be explained by reaching better ERAS adherence rates. However, the laparoscopic approach was also associated with anastomotic leakage. Despite the potential of bias, this study provides an insight in effects of ERAS and laparoscopic surgery in a non-randomized real-time setting.

Indexed as

Enhanced Recovery After SurgeryLaparoscopyRectal NeoplasmsHumansLength of StayPostoperative ComplicationsRectumEnhanced recoveryLaparoscopic resectionPostoperative outcomeRectal cancer

Identifiers

PMID34312719
OpenAlexW3185092064

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.