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Advances in Perioperative Care: Challenges and Perspectives in Enhanced Recovery after Surgery, Perioperative Optimization and Prehabilitation

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (25 February 2024) | Viewed by 7552

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Special Issue Editors

Dr. Carlos Cerdán Santacruz

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Guest Editor

1. Colorectal Surgery Unit, General Surgery Department, Hospital Universitario de la Princesa, Madrid, Spain
2. Colorectal Surgery Department, Clínica Santa Elena, 28003 Madrid, Spain
Interests: oncology; colorectal cancer; rectal cancer organ preservation; proctology; inflammatory bowel disease; functional disorders; fecal incontinence; minimally invasive surgery; robotic surgery; enhanced recovery after surgery; surgery prehabilitation

Dr. Gianluca Pellino

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Guest Editor

1. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
2. Colorectal Surgery, Vall d'Hebron University Hospital, Barcelona, Spain
Interests: artificial intelligence; prehabilitation; technologies in coloproctology; rectal cancer management; biomolecular diagnosis; translational research; robotic surgery; transanal surgery; inflammatory bowel diseases; colorectal cancer
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Dear Colleagues,

The field of perioperative care has undergone a real revolution over the last 25 years. The rapid spread of enhanced perioperative recovery pathways at first, and later of prehabilitation, has revolutionized the rules of management of patients scheduled for surgery. Despite this, the implementation of such strategies in many centers is suboptimal, and there are still many issues on which evidence is lacking.

The aim of this Special Issue is to serve as a forum to critically address the most relevant and, above all, some of the most unexplored aspects of perioperative medicine, from education, strategies for implementation, maintenance, possible areas for future improvement, and, most importantly, the long-term outcomes and patient-reported outcome measures.

Priority is given to high-quality, original studies, but well-designed and conducted systematic reviews (with or without a meta-analysis) are welcome. In summary, the Special Issue aims to increase clinicians’ knowledge of poorly explored areas of perioperative care, as well as to provide a balanced, sound, and evidence-based overview of the advances and potential perspectives in the field.

Dr. Carlos Cerdán Santacruz
Dr. Gianluca Pellino
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

perioperative care
enhanced recovery after surgery
prehabilitation
minimally invasive surgery
patient-related outcome measures
colorectal surgery
general surgery
thoracic surgery
vascular surgery
optimal functional recovery

Published Papers (3 papers)

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Research

11 pages, 1642 KiB

Open AccessArticle

The Use of Fissios App© as a Complement to a Face-to-Face Respiratory Physiotherapy Program versus an Attendance-Only Face-to-Face Physiotherapy Program in Patients Scheduled for Thoracic Surgical Procedures Reduces the Risk of Developing Postoperative Pulmonary Complications—A Quasi-Experimental Study

by Carlos Alfredo Fraile Olivero, José Ramón Jarabo Sarceda, Elena Fernández Martín, Verónica Alen Villamayor, Joaquín Calatayud Gastardi, Ana María Gómez Martínez, Passio Santos, Pedro Daniel Arribas Manzanal, Carlos Cerdán Santacruz and Florentino Hernando Trancho

J. Clin. Med. 2023, 12(21), 6774; https://doi.org/10.3390/jcm12216774 - 26 Oct 2023

Viewed by 838

Abstract

Postoperative pulmonary complications (PPCs) increase the hospital length of stay (LOS) and the cost of healthcare associated with surgical procedures. Strategies to reduce PPCs begin before surgery and continue in the postoperative period. Fissios App© is a smartphone application that contains perioperative medical advice and a structured respiratory physiotherapy program. The objective was to implement the use of this app in a group of patients scheduled for a thoracic surgical procedure and determine its efficacy in reducing PPCs. This was a quasi-experimental study in which all patients attended a face-to-face respiratory physiotherapy program, and the intervention group used Fissios App© as a complement. We prospectively recorded the postoperative evolution of both groups, analyzed the categorical differences and quantitative variables, and created a binary logistic regression model. We recruited 393 patients (131 intervention and 262 control). The intervention group had a lower incidence of PPCs (12.2% versus 24% in the control group, p = 0.006), a shorter LOS (a median of 3 days (IQR = 2–5) versus 4 days (IQR = 3–6, p = 0.001) in the control group), and a reduction in the risk of developing PPCs by 63.5% (OR: 0.365, 95% CI: 0.17–0.78). The use of Fissios App© improved the clinical outcomes after surgery and reduced the probability of developing PPCs. Full article

(This article belongs to the Special Issue Advances in Perioperative Care: Challenges and Perspectives in Enhanced Recovery after Surgery, Perioperative Optimization and Prehabilitation)

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12 pages, 715 KiB

Open AccessArticle

Utility of Cardiac Rehabilitation for Long-Term Outcomes in Patients with Hospital-Acquired Functional Decline after Cardiac Surgery: A Retrospective Study

by Kotaro Hirakawa, Atsuko Nakayama, Kentaro Hori, Reina Uewaki, Tomoki Shimokawa and Mitsuaki Isobe

J. Clin. Med. 2023, 12(12), 4123; https://doi.org/10.3390/jcm12124123 - 18 Jun 2023

Viewed by 1490

Abstract

Hospital-acquired functional decline is an important outcome that affects the long-term prognosis of patients after cardiac surgery. Phase II cardiac rehabilitation (CR) for outpatients is expected to improve prognosis; however, this is not clear in patients with hospital-acquired functional decline after cardiac surgery. Therefore, this study evaluated whether phase II CR improved the long-term prognosis of patients with hospital-acquired functional decline after cardiac surgery. This single-center, retrospective observational study included 2371 patients who required cardiac surgery. Hospital-acquired functional decline occurred in 377 patients (15.9%) after cardiac surgery. The mean follow-up period was 1219 ± 682 days in all patients, and there were 221 (9.3%) cases with major adverse cardiovascular events (MACE) after discharge during the follow-up period. The Kaplan–Meier survival curves indicated that hospital-acquired functional decline and non-phase II CR was associated with a higher incidence of MACE than other groups (log-rank, p < 0.001), additionally exhibiting prognosticating MACE in multivariate Cox regression analysis (HR, 1.59; 95% CI, 1.01–2.50; p = 0.047). Hospital-acquired functional decline after cardiac surgery and non-phase II CR were risk factors for MACE. The participation in phase II CR in patients with hospital-acquired functional decline after cardiac surgery could reduce the risk of MACE. Full article

(This article belongs to the Special Issue Advances in Perioperative Care: Challenges and Perspectives in Enhanced Recovery after Surgery, Perioperative Optimization and Prehabilitation)

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18 pages, 1365 KiB

Open AccessArticle

Multimodal Prehabilitation in Heart Transplant Recipients Improves Short-Term Post-Transplant Outcomes without Increasing Costs

by Manuel López-Baamonde, María José Arguis, Ricard Navarro-Ripoll, Elena Gimeno-Santos, Bárbara Romano-Andrioni, Marina Sisó, Silvia Terès-Bellès, Antonio López-Hernández, Adrià Burniol-García, Marta Farrero, Raquel Sebio-García, Elena Sandoval, María Sanz-de la Garza, Julián Librero, Ana García-Álvarez, María Ángeles Castel and Graciela Martínez-Pallí

J. Clin. Med. 2023, 12(11), 3724; https://doi.org/10.3390/jcm12113724 - 28 May 2023

Cited by 2 | Viewed by 4693

Abstract

(1) Background and aim: This study aimed to investigate the impact of prehabilitation on the postoperative outcomes of heart transplantation and its cost-effectiveness. (2) Methods: This single-center, ambispective cohort study included forty-six candidates for elective heart transplantation from 2017 to 2021 attending a multimodal prehabilitation program consisting of supervised exercise training, physical activity promotion, nutritional optimization, and psychological support. The postoperative course was compared to a control cohort consisting of patients transplanted from 2014 to 2017 and those contemporaneously not involved in prehabilitation. (3) Results: A significant improvement was observed in preoperative functional capacity (endurance time 281 vs. 728 s, p < 0.001) and quality-of-life (Minnesota score 58 vs. 47, p = 0.046) after the program. No exercise-related events were registered. The prehabilitation cohort showed a lower rate and severity of postoperative complications (comprehensive complication index 37 vs. 31, p = 0.033), lower mechanical ventilation time (37 vs. 20 h, p = 0.032), ICU stay (7 vs. 5 days, p = 0.01), total hospitalization stay (23 vs. 18 days, p = 0.008) and less need for transfer to nursing/rehabilitation facilities after hospital discharge (31% vs. 3%, p = 0.009). A cost-consequence analysis showed that prehabilitation did not increase the total surgical process costs. (4) Conclusions: Multimodal prehabilitation before heart transplantation has benefits on short-term postoperative outcomes potentially attributable to enhancement of physical status, without cost-increasing. Full article

(This article belongs to the Special Issue Advances in Perioperative Care: Challenges and Perspectives in Enhanced Recovery after Surgery, Perioperative Optimization and Prehabilitation)

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Advances in Perioperative Care: Challenges and Perspectives in Enhanced Recovery after Surgery, Perioperative Optimization and Prehabilitation

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