Perioperative strategy in colonic surgery; LAparoscopy and/or FAst track multimodal management versus standard care (LAFA trial)
Jan Wind,Jan Hofland,Benedikt Preckel,Markus W. Hollmann,Patrick M.M. Bossuyt,Dirk J. Gouma,Mark I. van Berge Henegouwen,Jan Willem Fuhring,Cornelis H. C. Dejong,Ronald M. van Dam,Miguel A. Cuesta,Astrid Noordhuis,Dick de Jong,Edith van Zalingen,Alexander Engel,T Hauwy Goei,I Erica de Stoppelaar,Willem F. van Tets,Bart A. van Wagensveld,Annemiek Swart,Maarten J L J van den Elsen,Michael F. Gerhards,Laurens Th de Wit,Muriel A M Siepel,Anna A. W. van Geloven,Jan-Willem Juttmann,Wilfred Clevers,Willem A. Bemelman +27 more
TLDR
The randomized controlled multicenter LAFA-trial was conceived to determine whether laparoscopic surgery, fast track perioperative care or a combination of both is to be preferred over open surgery with standard care in patients having segmental colectomy for malignant disease.Abstract:
Background
Recent developments in large bowel surgery are the introduction of laparoscopic surgery and the implementation of multimodal fast track recovery programs. Both focus on a faster recovery and shorter hospital stay.
The randomized controlled multicenter LAFA-trial (LAparoscopy and/or FAst track multimodal management versus standard care) was conceived to determine whether laparoscopic surgery, fast track perioperative care or a combination of both is to be preferred over open surgery with standard care in patients having segmental colectomy for malignant disease.read more
Citations
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Guidelines for perioperative care in elective colonic surgery: Enhanced recovery after surgery (ERAS®) society recommendations
Ulf Gustafsson,Michael J. Scott,Michael J. Scott,W. Schwenk,Nicolas Demartines,Didier Roulin,Nader K. Francis,Clare McNaught,John MacFie,A. S. Liberman,Mattias Soop,Andrew G. Hill,Robin H. Kennedy,Dileep N. Lobo,Kenneth C. H. Fearon,Olle Ljungqvist,Olle Ljungqvist +16 more
TL;DR: Based on the evidence available for each item of the multimodal perioperative care pathway, the Enhanced Recovery After Surgery (ERAS) Society, International Association for Surgical Metabolism and Nutrition (IASMEN) and European Society for Clinical Nutrition and Metabolicism (ESPEN) present a comprehensive evidence-based consensus review of peri operative care for colonic surgery.
Journal ArticleDOI
Consensus review of optimal perioperative care in colorectal surgery: Enhanced Recovery After Surgery (ERAS) Group recommendations.
Kristoffer Lassen,Mattias Soop,Jonas Nygren,P. Boris W. Cox,P. O. Hendry,Claudia Spies,Maarten F. von Meyenfeldt,Kenneth C. H. Fearon,Arthur Revhaug,Stig Norderval,Olle Ljungqvist,Dileep N. Lobo,Cornelis H. C. Dejong +12 more
TL;DR: The Enhanced Recovery After Surgery (ERAS) Group presents a comprehensive evidence-based consensus review of perioperative care for colorectal surgery based on the evidence available for each element of the multimodal peri operative care pathway.
Journal ArticleDOI
Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations.
Ulf Gustafsson,Michael J. Scott,Michael J. Scott,W. Schwenk,Nicolas Demartines,Didier Roulin,Nader K. Francis,Clare McNaught,John MacFie,A. S. Liberman,Mattias Soop,Andrew G. Hill,Robin H. Kennedy,Dileep N. Lobo,Kenneth C. H. Fearon,Olle Ljungqvist,Olle Ljungqvist +16 more
TL;DR: Based on the evidence available for each item of the multimodal perioperative-care pathway, the Enhanced Recovery After Surgery (ERAS) Society, International Association for Surgical Metabolism and Nutrition (IASMEN) and European Society for Clinical Nutrition and Metabolicism (ESPEN) present a comprehensive evidence-based consensus review of peri operative care for colonic surgery.
Journal ArticleDOI
Laparoscopy in Combination with Fast Track Multimodal Management is the Best Perioperative Strategy in Patients Undergoing Colonic Surgery A Randomized Clinical Trial (LAFA-study)
Malaika S. Vlug,Jan Wind,Markus W. Hollmann,Dirk T. Ubbink,Huib A. Cense,Alexander Engel,Michael F. Gerhards,Bart A. van Wagensveld,Edwin S. van der Zaag,Anna A. W. van Geloven,Mirjam A. G. Sprangers,Miguel A. Cuesta,Willem A. Bemelman +12 more
TL;DR: Optimal perioperative treatment for patients requiring segmental colectomy for colon cancer is laparoscopic resection embedded in a FT program, and if open surgery is applied, it is preferentially done in FT care.
Journal ArticleDOI
Fast track surgery versus conventional recovery strategies for colorectal surgery
TL;DR: The quality of trials and lack of sufficient other outcome parameters do not justify implementation of ERAS as the standard of care, but analysis shows a reduction in overall complications, but major complications were not reduced.
References
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Antonio M. Lacy,Juan Carlos García-Valdecasas,Salvadora Delgado,Antoni Castells,Pilar Taura,Josep M. Piqué,Josep Visa +6 more
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Henrik Kehlet,Douglas W. Wilmore +1 more
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Minimally invasive colon resection (laparoscopic colectomy).
TL;DR: Although laparoscope-assisted colonic surgery may still be considered a procedure in evolution, it has the potential to be as popular as laparoscopic cholecystectomy, according to clinical investigators.
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Enhanced recovery after surgery
TL;DR: A protocol is presented which is in current use by the ERAS Group and may provide a standard of care against which either current or future novel elements of an enhanced recovery approach can be tested for their effect on outcome.
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