Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced recovery after surgery (ERAS®) Society Recommendations - Part I: Preoperative and intraoperative management.

{"article_title":"Guidelines for Perioperative Care in Cytoreductive Surgery (CRS) with or without hyperthermic IntraPEritoneal chemotherapy (HIPEC): Enhanced recovery after surgery (ERAS\u00ae) Society Recommendations - Part I: Preoperative and intraoperative management.","author":"H\u00fcbner M, Kusamura S, Villeneuve L, Al-Niaimi A, Alyami M, Balonov K, Bell J, Bristow R, Guiral DC, Fagotti A, Falc\u00e3o LFR, Glehen O, Lambert L, Mack L, Muenster T, Piso P, Pocard M, Rau B, Sgarbura O, Somashekhar SP, Wadhwa A, Altman A, Fawcett W, Veerapong J, Nelson G","journal_title":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology","issn":"1532-2157","isbn":"","publication_date":"2020-12-01","volume":"46","issue":"12","first_page":"2292","page_count":"","accession_number":"32873454","doi":"10.1016\/j.ejso.2020.07.041","publisher":"Elsevier","doctype":"Consensus Development Conference","subjects":"Cytoreduction Surgical Procedures methods; Enhanced Recovery After Surgery; Hyperthermic Intraperitoneal Chemotherapy methods; Intraoperative Care methods; Peritoneal Neoplasms therapy; Preoperative Care methods; Delphi Technique; Humans; Perioperative Care","interest_area":["Oncology"],"abstract":"Background: Enhanced recovery after surgery (ERAS) pathways have been shown to considerably reduce complications, length of stay and costs after most of surgical procedures by standardised application of best evidence-based perioperative care. The aim was to elaborate dedicated recommendations for cytoreductive surgery (CRS) \u00b1 hyperthermic intraperitoneal chemotherapy (HIPEC) in a two-part series of guidelines based on expert consensus. The present part I of the guidelines highlights preoperative and intraoperative management. Methods: The core group assembled a multidisciplinary panel of 24 experts involved in peritoneal surface malignancy surgery representing the fields of general surgery (n = 12), gynaecological surgery (n = 6), and anaesthesia (n = 6). Experts systematically reviewed and summarized the available evidence on 72 identified perioperative care items, following the GRADE (grading of recommendations, assessment, development, evaluation) system. Final consensus (defined as \u226550%, or \u226570% of weak\/strong recommendations combined) was reached by a standardised 2-round Delphi process, regarding the strength of recommendations. Results: Response rates were 100% for both Delphi rounds. Quality of evidence was evaluated high, moderate low and very low, for 15 (21%), 26 (36%), 29 (40%) and 2 items, respectively. Consensus was reached for 71\/72(98.6%) items. Strong recommendations were defined for 37 items, No consensus could be reached regarding the preemptive use of fresh frozen plasma. Conclusion: The present ERAS recommendations for CRS\u00b1HIPEC are based on a standardised expert consensus process providing clinicians with valuable guidance. There is an urgent need to produce high quality studies for CRS\u00b1HIPEC and to prospectively evaluate recommendations in clinical practice. Competing Interests: Declaration of competing interest All other authors declare to have no disclosures.This information has been provided by all authors individually in their attached author forms with date and signatures. Copyright \u00a9 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.","url":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&db=mdl&AN=32873454","isPdfLink":false,"isSAML":false,"an":"32873454","number_other":"","type_pub":"","issn_electronic":"1532-2157","languages":"English","language":"eng","date_entry":"Date Created: 20200903 Date Completed: 20210301 Latest Revision: 20210301","date_update":"20240104","titleSource":"European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2020 Dec; Vol. 46 (12), pp. 2292-2310. Date of Electronic Publication: 2020 Aug 25.","date_pub_cy":"","type_document":"","contract_publisher":"","authored_on":"2020-12-01","description":"Background: Enhanced recovery after surgery (ERAS) pathways have been shown to considerably reduce complications, length of stay and costs after most of surgical procedures by standardised application of best evidence-based perioperative care. The aim was to elaborate dedicated recommendations for cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC) in a two-part series of guidelines based on expert consensus. The present part I of the guidelines highlights preoperative and intraoperative management.<br \/>Methods: The core group assembled a multidisciplinary panel of 24 experts involved in peritoneal surface malignancy surgery representing the fields of general surgery (n = 12), gynaecological surgery (n = 6), and anaesthesia (n = 6). Experts systematically reviewed and summarized the available evidence on 72 identified perioperative care items, following the GRADE (grading of recommendations, assessment, development, evaluation) system. Final consensus (defined as \u226550%, or \u226570% of weak\/strong recommendations combined) was reached by a standardised 2-round Delphi process, regarding the strength of recommendations.<br \/>Results: Response rates were 100% for both Delphi rounds. Quality of evidence was evaluated high, moderate low and very low, for 15 (21%), 26 (36%), 29 (40%) and 2 items, respectively. Consensus was reached for 71\/72(98.6%) items. Strong recommendations were defined for 37 items, No consensus could be reached regarding the preemptive use of fresh frozen plasma.<br \/>Conclusion: The present ERAS recommendations for CRS±HIPEC are based on a standardised expert consensus process providing clinicians with valuable guidance. There is an urgent need to produce high quality studies for CRS±HIPEC and to prospectively evaluate recommendations in clinical practice.<br \/>Competing Interests: Declaration of competing interest All other authors declare to have no disclosures.This information has been provided by all authors individually in their attached author forms with date and signatures.<br \/> (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)","upload_link":"https:\/\/search.ebscohost.com\/login.aspx?direct=true&site=eds-live&scope=site&db=mdl&AN=32873454&authtype=shib&custid=ns346513&group=main&profile=eds","no_of_pages":"","authored_by":"H\u00fcbner M, Kusamura S, Villeneuve L, Al-Niaimi A, Alyami M, Balonov K, Bell J, Bristow R, Guiral DC, Fagotti A, Falc\u00e3o LFR, Glehen O, Lambert L, Mack L, Muenster T, Piso P, Pocard M, Rau B, Sgarbura O, Somashekhar SP, Wadhwa A, Altman A, Fawcett W, Veerapong J, Nelson G"}