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Master Thesis

Diminution de la durée de séjour hospitalier par la mise en place d’un protocole de récupération rapide (ERAS) après remplacement valvulaire aortique par mini-sternotomie

Abstract : Background: there is presently a warm enthusiasm for enhanced recovery after surgery (ERAS) program. The literature clearly indicates that such program could shorten the hospital length of stay and could improve patient outcome. However, most of the studies conducted encompassed mainly colorectal and orthopedic surgeries. Thus, in an effort to provide more evidence to the literature, we have investigated prospectively the feasibility and clinical effectiveness of a dedicated ERAS program for mini-invasive Aortic Valve Replacements (MIAVR). Methods: after ethic committee approval, data of consecutive patients scheduled for a MIAVR via a mini-sternotomy were collected prospectively during 2 time periods, before (MIAVR group) and after implementation of a dedicated ERAS pathway specifically designed for this procedure (MIAVR-ERAS group). Patients’ demographics, patients’ characteristics, compliance to the ERAS protocol, postoperative morphine consumption, postoperative pain scores, postoperative complications, hospital length of stay and hospital readmission rate were collected. Results: there were 23 patients enrolled in each group. Patients enrolled in the new protocol had significantly lower postoperative pain scores (P = 0.03), a trend toward a shorter time to extubation (P = 0.08), as well as a trend toward less pulmonary infection (P = 0.06). The median hospital length of stay was 10[9-13.5] and 7[6.5-8] days in the traditional MIAVR group and in the MIAVR-ERAS group, respectively (P < 0.001). Conclusions: an ERAS pathway planned for mini-invasive AVR seems feasible and associated with a shorter length of hospital stay and with a trend towards both less opioid consumption and less postoperative complications.
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Submitted on : Monday, December 16, 2019 - 4:07:43 PM
Last modification on : Wednesday, December 18, 2019 - 1:30:47 AM
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  • HAL Id : dumas-02414423, version 1

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Savva Assatourian. Diminution de la durée de séjour hospitalier par la mise en place d’un protocole de récupération rapide (ERAS) après remplacement valvulaire aortique par mini-sternotomie. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02414423⟩

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