Evidence map›Paper›PMID 36811742›Full record

Observational studyLangenbeck's archives of surgery2023

Enhanced recovery pathway in open and minimally invasive colorectal cancer surgery: a prospective study on feasibility, compliance, and outcomes in a high-volume resource limited tertiary cancer center.

Martin Thomas, Vandana Agarwal, Ashwin DeSouza, Riddhi Joshi, Minal Mali, Karuna Panhale, Omkar K Salvi, Reshma Ambulkar, Shailesh Shrikhande, Avanish Saklani

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
3.2field-weighted citation impact, top 9% 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

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
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

10 authors at 2 institutions in 2 countries.

Martin ThomasDepartment of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-3533-2860
Vandana AgarwalDepartment of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India. vandanachaukar@hotmail.com.ORCID http://orcid.org/0000-0002-3593-0414
Ashwin DeSouzaDepartment of Gastrointestinal Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-2722-0826
Riddhi JoshiDepartment of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-3974-3149
Minal MaliDepartment of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-4672-5539
Karuna PanhaleResearch Nurse, Department of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0003-4530-4713
Omkar K SalviResearch Statistician, Clinical Research Secretariat, Tata Memorial Centre, Homi Bhabha National Institute, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-2111-8310
Reshma AmbulkarDepartment of Anaesthesia, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-3353-4303
Shailesh ShrikhandeDepartment of Gastrointestinal and HPB Surgery, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0002-8036-4212
Avanish SaklaniDepartment of Gastrointestinal Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, 400012, India.ORCID http://orcid.org/0000-0003-4498-7612
Homi Bhabha National Institute · INRoyal Adelaide Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced recovery program (ERP) has demonstrated improved postoperative outcomes with increased compliance to pathway. However, there is scarce data on feasibility and safety in resource limited setting. The objective was to assess compliance with ERP and its impact on postoperative outcomes and return to intended oncological treatment (RIOT).

methodsA single center prospective observational audit was conducted from 2014 to 2019, in elective colorectal cancer surgery. Before implementation, multi-disciplinary team was educated regarding ERP. Compliance to ERP protocol and its elements was recorded. Impact of quantum of compliance (≥80% vs. <80%) to ERP on postoperative morbidity, mortality, readmission, stay, re-exploration, functional GI recovery, surgical-specific complications, and RIOT was evaluated for open and minimal invasive surgery (MIS).

resultsDuring study, 937 patients underwent elective colorectal cancer surgery. Overall compliance with ERP was 73.3%. More than 80% compliance was observed in 332 (35.4%) patients in the entire cohort. Patients with <80% compliance had significantly higher overall, minor and surgery-specific complications, longer postoperative stay, delayed functional GI recovery for both open and MIS procedures. RIOT was observed in 96.5% patients. Duration to RIOT was significantly shorter following open surgery with ≥80% compliance. Compliance <80% to ERP was identified as one of the independent predictors for developing postoperative complications.

conclusionThe study demonstrates beneficial impact of increased compliance to ERP on postoperative outcomes following open and minimally invasive surgery for colorectal cancer. Within a resource limited setting, ERP was found to feasible, safe, and effective in both open and minimally invasive colorectal cancer surgery.

Indexed as

Colorectal NeoplasmsGastrointestinal DiseasesFeasibility StudiesHumansLength of StayMinimally Invasive Surgical ProceduresPostoperative ComplicationsProspective StudiesRetrospective StudiesColorectal cancerEnhanced recovery after surgeryEnhanced recovery pathwayEnhanced recovery programMinimally invasive surgeryPostoperative complicationsReturn to intended oncological treatment

Identifiers

PMID36811742
OpenAlexW4321480665

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.