Evidence map›Paper›PMID 37973430›Full record

ArticleSurgery2024

Early observations with an ERAS pathway for thyroid and parathyroid surgery: Moving the goalposts forward.

Nikita Machado, Ryland Mortlock, Richard Maduka, Ana Eliza Souza Cunha, Ethan Dyer, Anne Long, Joseph K Canner, Anthony Tanella, Courtney Gibson, Jaime Hyman and 1 more

Registry-linked trialOpen access · greenAbstract read
In one paragraph

Article in Surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07575243 (A Comprehensive Enhanced Recovery After Surgery), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.3field-weighted citation impact, top 19% 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.

NCT07575243 completednot on this map

A Comprehensive Enhanced Recovery After Surgery (ERAS) Protocol for Thyroidectomy

TypeobservationalSponsorAssiut UniversityRan2024 to 2025Enrolled143ConditionsThyroid Diseases, Goiter, Thyroid NeoplasmsArmsEnhanced Recovery After Surgery protocol, Conventional perioperative care
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Nikita MachadoSection of Endocrine Surgery, Yale New Haven Hospital, New Haven, CT. Electronic address: https://twitter.com/NikitaMachado.
Ryland MortlockMedical Scientist Training Program, Yale University School of Medicine, New Haven, CT.
Richard MadukaDepartment of Surgery, Yale New Haven Hospital, New Haven, CT. Electronic address: https://twitter.com/RylandMortlock.
Ana Eliza Souza CunhaPhysician Associate Program, Yale New Haven Hospital, New Haven, CT.
Ethan DyerDepartment of Anesthesiology, Yale School of Medicine, New Haven, CT.
Anne LongYale New Haven Hospital, New Haven, CT.
Joseph K CannerDepartment of Surgery, Yale New Haven Hospital, New Haven, CT.
Anthony TanellaDepartment of Anesthesiology, Yale School of Medicine, New Haven, CT.
Courtney GibsonSection of Endocrine Surgery, Yale New Haven Hospital, New Haven, CT.
Jaime HymanDepartment of Anesthesiology, Yale School of Medicine, New Haven, CT. Electronic address: https://twitter.com/JaimeHyman.
Jennifer OgilvieSection of Endocrine Surgery, Yale New Haven Hospital, New Haven, CT. Electronic address: Jennifer.ogilvie@yale.edu.
Yale New Haven Hospital · USTwitter (United States) · USYale University · US

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Medical Scientist Training ProgramT32GM136651 · NIGMS · YALE UNIVERSITY · PI BARBARA I KAZMIERCZAK · 2020 to 2026
$16.5M
NCATS NIH HHS UL1 TR001863NIGMS NIH HHS T32 GM136651
6 · The paper itself

Abstract

backgroundEnhanced recovery after surgery pathways have become the standard of care in various surgical specialties. In this study, we discuss our initial experience with a staged enhanced recovery after surgery pathway in endocrine surgery and assess the impact of this pathway on select perioperative outcomes and unanticipated admissions.

methodsWe collected information regarding all thyroid/parathyroid surgeries performed by endocrine surgeons at our institution before and after the implementation of the multi-intervention enhanced recovery after surgery pathway. We compared relevant outcomes for all cases 1 year before (n = 479) and 1 year after (n = 166) implementation of the pathway. We also compared outcomes between enhanced recovery after surgery patient groups with varying levels of enhanced recovery after surgery compliance.

resultsEnhanced recovery after surgery was associated with a significant decrease in total length of stay (9.2 vs 7.5 hours, P < .0001). Whereas there was no significant decrease in all-cause unanticipated postoperative admissions, there was a decrease in patient-initiated admissions in the Enhanced recovery after surgery group. There was also a significant decrease in mean postoperative morphine milligram equivalents (14.4 vs 16.2 vs 24.8, P = .0015), average daily morphine milligram equivalents (25.6 vs 45.6 vs 53, P < .0001), and average daily pain scores (1.89 vs 2.38 vs 2.74, P = .0045) in the Enhanced recovery after surgery group (particularly with increasing Enhanced recovery after surgery compliance). There were no significant differences in the requirement for postoperative antiemetics or in the post-anesthesia care unit length of stay.

conclusionThis study demonstrates a significant benefit from Enhanced recovery after surgery pathways for thyroidectomies and parathyroidectomies, even with initial data and a staggered roll-out plan. Further directions include a follow-up study once we reach a higher level of institutional compliance with all components of the Enhanced Recovery After Surgery pathway and a prospective trial to identify the relative significance of different portions of the Enhanced Recovery after Surgery pathway, particularly the superficial cervical plexus block.

Indexed as

Morphine DerivativesThyroid GlandAnalgesics, OpioidHumansLength of StayPostoperative ComplicationsPostoperative PainAnalgesics, OpioidMorphine Derivatives

Identifiers

PMID37973430
PMCPMC10838521
OpenAlexW4388686918

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

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.