• 한국간담췌외과학회지
• /
• 제28권3호
• /
• pp.344-349
• /
• 2024

Backgrounds/Aims: The implementation of enhanced recovery after surgery (ERAS) protocols has demonstrated significant advantages for patients by mitigating surgical stress and expediting recovery across a spectrum of surgical procedures worldwide. This investigation seeks to assess the effectiveness of the ERAS protocol specifically in the context of major liver resections within our geographical region. Methods: Our department conducted retrospective analysis of prospectively collected data, gathered from consenting individuals who underwent liver resections from January 2018 to December 2023. The assessment encompassed baseline characteristics, preoperative indications, surgical outcomes, and postoperative complications among patients undergoing liver surgery. Results: Among the included 184 patients (73 standard care, 111 ERAS program), the baseline characteristics were similar. Median postoperative hospital stay differed significantly: 5 days (range: 3-13 days) in ERAS, and 11 days (range: 6-22 days) in standard care (p < 0.001). Prophylactic abdominal drainage was less in ERAS (54.9%) than in standard care (86.3%, p < 0.001). Notably, in ERAS, 88.2% initiated enteral feeding orally on postoperative day 1, significantly higher than in standard care (47.9%, p < 0.001). Early postoperative mobilization was more common in ERAS (84.6%) than in standard care (36.9%, p < 0.001). Overall complication rates were 21.9% in standard care, and 8.1% in ERAS (p = 0.004). Conclusions: Our investigation highlights the merits of ERAS protocol; adherence to its diverse components results in significant reduction in hospital length of stay, and reduced occurrence of postoperative complications, improving short-term recovery post liver resection.

• 대한한방부인과학회지
• /
• 제35권3호
• /
• pp.88-104
• /
• 2022

Objectives: The purpose of this study is to report the effectiveness and satisfaction of traditional Korean medicine (TKM) for enhanced recovery after surgery (ERAS) after gynecological surgery. Methods: The study is conducted by analyzing the medical records of hospitalized patients in a Korean medicine hospital. Sixty-five patients who received TKM for ERAS after gynecological surgery from May 2020 to July 2021 were included. We performed statistical analysis by using SPSS ver. 25.0. To verify the effect of TKM for ERAS, we analyzed improvement of symptoms. Also, we analyzed survey of patients' satisfaction to verify the satisfaction of TKM for ERAS. Results: Among the symptoms of pain, there was a statistically significant decrease in all types of pain on the questionnaire. Other systemic symptoms showed statistically significant improvement in all symptoms on the questionnaire. The satisfaction level questionnaires for TKM for ERAS showed a mean value of 4.37±0.63 out of 5-point scale. Especially, herbal medicine, acupuncture, and moxibustion showed high satisfaction without dissatisfaction. Conclusions: The result has shown that TKM for ERAS after gynecological surgery is effective and the satisfaction of the patients is high. Further study on TKM for ERAS for quality of life assessment is needed.

• Journal of Gastric Cancer
• /
• 제19권1호
• /
• pp.72-82
• /
• 2019

Purpose: Despite its clinical benefits, enhanced recovery after surgery (ERAS) is less widely implemented for gastric cancer surgery. This nationwide survey investigated the current status of the implementation of ERAS in perioperative care for gastric cancer surgery in South Korea. Materials and Methods: This survey enrolled 89 gastric surgeons from 52 institutions in South Korea. The questionnaire consisted of 24 questions about the implementation of the ERAS protocols in the management of gastric cancer surgery. The survey was carried out using an electronic form sent via email. Results: Of the 89 gastric surgeons, 58 (65.2%) answered that they have knowledge of the concept and details of ERAS, 45 (50.6%) of whom were currently applying ERAS for their patients. Of the ERAS protocols, preoperative education (91.0%), avoidance of preoperative fasting (68.5%), maintenance of intraoperative normothermia (79.8%), thromboprophylaxis (96.5%), early active ambulation (64.4%), and early removal of urinary catheter (68.5%) were relatively well adopted in perioperative care. However, other practices, such as avoidance of preoperative bowel preparation (41.6%), provision of preoperative carbohydrate-rich drink (10.1%), avoidance of routine abdominal drainage (31.4%), epidural anesthesia (15.9%), single-dose prophylactic antibiotics (19.3%), postoperative high oxygen therapy (36.8%), early postoperative diet (14.6%), restricted intravenous fluid administration (53.9%), and application of discharge criteria (57.3%) were not very well adopted for patients. Conclusions: Perioperative management of gastric cancer surgery is largely heterogeneous among gastric surgeons in South Korea. Standard perioperative care based on scientific evidence needs to be established to improve the quality of surgical care and patient outcomes.

• 대한한방부인과학회지
• /
• 제32권3호
• /
• pp.142-161
• /
• 2019

Objectives: The purpose of this study is to report the effect and safety of traditional Korean medicine (TKM) for enhanced recovery after surgery (ERAS) after gynecological surgery. Methods: The study is conducted by analyzing the medical records of the hospitalized patients in TKM hospital. Eighty-six patients were enrolled who received TKM for ERAS after gynecological surgery from January 2015 to April 2018. We performed statistical analysis by using SPSS ver. 25.0. To prove the effect and safety of TKM for ERAS, we analyzed symptoms and Hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and serum creatinine (Cr) with glomerular filtration rate (GFR). In addition, we checked other adverse reactions that the patients complained to prove the safety of TKM for ERAS. Results: Among symptoms of pain, there was a statistically significant decrease in abdominal pain, lower back pain, and shoulder pain. Other symptoms showed statistically significant improvement in fatigue, abdominal tympanosis, operation-site discomfort, dizziness, urinary discomfort, throat discomfort, constipation, dyspepsia and colporrhagia. Anemia in both ferritin combination treatment group and herbal medicine only group showed significant improvement. There was no liver damage or renal damage by TKM. Conclusions: The result has shown that TKM for ERAS after gynecological surgery is effective and safe. The further study of TKM for ERAS with more patients is needed.

• Clinical Nutrition Research
• /
• 제11권2호
• /
• pp.75-83
• /
• 2022

This study sought to investigate the effects of the enhanced recovery after surgery (ERAS) program on postoperative recovery and nutritional status in patients with colorectal cancer undergoing laparoscopic surgery. A total of 37 patients were included: 19 in the experimental group and 18 in the control group. The experimental group was supplemented with carbohydrate drinks before and after surgery, and the control group was maintained with fasting and water intake in the traditional method. Both care management and nutrition education were implemented for both groups. Patients were evaluated for physical condition, clinical indicators, blood tests, pain, length of stay, nutritional status, and nutrient intake. Use of the ERAS program for the experimental group resulted in shorter length of stay (p = 0.006), less pain (p < 0.001), and a lower rate of malnutrition (p = 0.014) compared with controls. In conclusion, carbohydrate drinks provide great advantages by reducing discomfort, such as pain or thirst, during fasting in patients after colon cancer surgery, helping patients to eat comfortably and actively, minimizing insulin resistance, maintaining nitrogen balance, and reducing infection and anastomosis leakage. For use of ERAS as a standardized program, repeated and expanded research is needed, and a Korean-style ERAS should be prepared by using this approach for various diseases.

• Journal of Gastric Cancer
• /
• 제18권3호
• /
• pp.230-241
• /
• 2018

Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GCERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015-October 1, 2016) with the historical control (HC) group (January 1, 2012-October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.

• 한국간담췌외과학회지
• /
• 제28권1호
• /
• pp.80-91
• /
• 2024

Backgrounds/Aims: Optimal intravenous fluid management during the perioperative period for patients undergoing pancreaticoduodenectomy (PD) within the framework of enhanced recovery after surgery (ERAS) is unclear. Studies have indicated that excessive total body salt and water can contribute to the development of oedema, leading to increased morbidity and extended hospital stays. This study aimed to assess the effects of an intravenous therapy regimen during postoperative day (POD) 0 to 2 in PD patients within ERAS. Methods: A retrospective interventional cohort study was conducted, and it involved all PD patients before and after implementation of ERAS (2009-2017). In the ERAS group, a targeted maintenance fluid regimen of 20 mL/kg/day with a sodium requirement of 0.5 mmoL/kg/day was administered. Outcome measures included the mmol of sodium and chloride administered, length of stay, and morbidity (postoperative pancreatic fistula, POPF; acute kidney injury, AKI; ileus). Results: The study included 169 patients, with a mean age of 64 ± 11.3 years. Following implementation of the intravenous fluid therapy protocol, there was a significant reduction in chloride and sodium loading. However, in the multivariable analysis, chloride administered (mmoL/kg) did not independently influence the length of stay; or rates of POPF, ileus, or AKI (p > 0.05). Conclusions: The findings suggested that a postoperative intravenous fluid therapy regimen did not significantly impact morbidity. Notably, there was a trend towards reduced length of stay within an increasingly comorbid patient cohort. This targeted fluid regimen appears to be safe for PD patients within the ERAS program. Further prospective research is needed to explore this area.

• 한국잡초학회지
• /
• 제9권2호
• /
• pp.141-148
• /
• 1989

전국(全國)의 각(各) 지역(地域)에서 채집(採集)한 피는 외부형태적(外部形態的)으로는 매우 큰 차이(差異)를 보였으나 Yabuno가 제시(提示)한 종자(種子)의 포영 길이와 생육습성(生育習性)에 따라 분류(分類)하면 E.oryzicola 와 E.crus-galli var. crus-galli, 및 var. praticola 로 대별(大別)할 수 있었다. E. oryzicola는 외부형태적(外部形態的)으로 벼와 유사(類似)하여 초장(草長)이 비교적 작고 직립형(直立型)으로 까락이 없으며 출수기(出穗期)가 대체로 늦은 편이었고 종내변이(種內變異)가 적었다. 그러나 E. crus-galli var. crus-galli 와 var. praticola는 외부형태적(外部形態的)으로 다양(多樣)한 차이(差異)를 보이고 있어서 외부형태(外部形態)만으로 분류(分類)가 어려웠다. E. crus-galli var. crus-galli의 초장(草長), 분얼수(分蘖數), 수수장(穗穗長) 등(等)의 변이폭(燮異幅)이 매우 컸고 E. crus-galli var. praticola 도 비슷한 경향(傾向)을 나타내었다. 우리나라에 분포(分布)하는 피는 외형(外形)의 차이(差異)가 다양(多樣)함에도 불구하고 3정내외(種內外)로 분류(分類)되고 있으며 금후 세포학적(細胞學的)또는 생화학적(生化學的) 관찰(觀察)을 통(通)해 확정(確定)될 수 있을 것이다. 피 3종(種)의 제초제(除草劑)에 대(對)한 반응(反應)은 종내(種內)또는 종간(種間)에서 공(共)히 조사(調査)되었으며 상대적(相對的) 내성(耐性)과 감수성(感受性)의 차이(差異)를 확인할 수 있었다.

• 한국식생활문화학회지
• /
• 제26권3호
• /
• pp.239-248
• /
• 2011

This article examines the types of Jwabans as recorded in 21 old books of the Joseon dynasty (1392-1909). The ingredients used in Jwabans during the Joseon dynasty were root vegetables, sea algae, seeds nuts, bird, meat, and fish. In the early, middle, and late eras of the Joseon dynasty, 10, nine, and 181 kinds of Jwabans were prepared, and two, one, and seven kinds of Jwabans were prepared using root vegetables (根菜類). During the early and late eras of the Joseon dynasty, one and 14 kinds of Jwabans were prepared using sea algae (海藻類), respectively, and four kinds of Jwabans were prepared using seeds nuts during late eras of the Joseon dynasty (種實類). During the early, mid and late eras, one, two, and 17 kinds of Jwabans were prepared using bird (鳥類), three, one, and 47 kinds of Jwabans were prepared using meat (肉類), and one, five, and 81 kinds of Jwabans were prepared using fish (魚類). The frequency of the Jwabans ingredients in order were fish (30.5%), meat (23.5%), pheasant (7%), root vegetables (5%), abalone (全鰒) (5%), laver (海苔) (4%), shellfish (貝類) (3%), fish eggs (魚卵) (2.5%), fleshy prawn (大蝦) (2.5%), sea tangle (昆布) (2%), dried tangle (海草) (1.5%), sparrow meat (雀肉) (1.5%), and etc during the Joseon dynasty. It seems that the appearance and supplementation with different ingredients increased throughout the Joseon dynasty. This may be associated with the commercial industrial development that prevailed during the late Joseon dynasty. Further study will be conducted on recipes and ingredients recorded in these old books to develop a standardized recipe to globalize Jwabans.

• 한국식생활문화학회지
• /
• 제25권1호
• /
• pp.25-35
• /
• 2010

This article examines the types of tteok (Korean rice cake) recorded in 21 old literatures of the Joseon dynasty (1392-1909) according to its main ingredients. Tteok varieties of the Joseon dynasty were categorized into jjin-tteok, chin-tteok, jijin-tteok, salmeun-tteok and guun-tteok and their changes in cooking method were discussed from the early to late eras of the Joseon dynasty. These can be summarized as follows. In the early, middle and late eras of the Joseon dynasty, there were 1, 15 and 84 kinds of tteok using non-glutinous rice as the main ingredient, and 6, 24 and 120 kinds using glutinous rice, respectively. Tteok using wheat flour was not found in the early Joseon dynasty, whereas 6 and 32 kinds were found in the middle and late eras, respectively. There were 1, 4 and 5 kinds of tteoks using buckwheat, and 5, 11 and 19 kinds using other ingredients such as yam, barley, elephant's ear, oat, and arrowroot flour, in the early, middle and late eras, respectively. The frequency of the main ingredient increased in the order of glutinous rice>non-glutinous rice>wheat flour>other ingredient>buckwheat flour during the Joseon dynasty and the ratio of tteoks using non-glutinous and glutinous rice flours was 1:1.5. The number and types of tteok were noted to increase abruptly throughout the Joseon dynasty. This may be associated with the commercial industrial development that prevailed in the late Joseon dynasty. Further study will be conducted on their recipes and ingredients recorded in these old literatures to develop a standardized recipe for the globalization of tteok.