Comparative-effectiveness of surgical innovations aimed to enhance postoperative recovery
Summary of Research
In recent years, enhanced recovery pathways (ERPs, i.e. perioperative care programs including multiple interventions aimed to improve postoperative recovery) have innovated how we care for surgical patients. However, the implementation and maintenance of these programs are complex and require substantial resource allocation. Although successful ERPs may comprise up to 20 different interventions implemented in the pre-, intra- and post-operative periods, the relative contribution of each intervention is still uncertain. Thus, this segment of the research program aims to contribute evidence regarding the comparative effectiveness of ERPs, with particular focus on understanding the relative contribution of specific ERP interventions.Projects in this field include a randomized controlled trial (RCT), a first-ever systematic review summarizing the evidence of the impact of ERPs on outcomes after lung resection, and a comprehensive meta-analysis of the impact of Alvimopan, a peripherally acting μ-opioid antagonist drug, on postoperative gastrointestinal dysfunction (ileus).
Publications
(*Denotes role as supervisor of the first author)- Carli F, Bousquet-Dion G, Awasthi R, Elsherbini N, Liberman S, Boutros M, Stein B, Charlebois P, Ghitilescu G, MD, Morin N, Jagoe T, Scheede-Bergdahl C, Minnella EM, Fiore JF Jr. Multimodal Prehabilitation for Frail Patients Undergoing Resection of Colorectal Cancer. A Randomized Controlled Trial. JAMA Surg 2020;155(3):233-242. DOI
- Fiore JF Jr, Feldman LS. Tracking Postoperative Recovery-Making a Case for Smartphone Technology. JAMA Surg 2019. doi: 10.1001/jamasurg.2019.4703. DOI
- Karimian N, Kaneva P, Donatelli F, Stein B, Liberman AS, Charlebois P, Lee L, Fiore JF Jr, Carli F, Feldman LS. Simple versus complex preoperative carbohydrate drink to preserve perioperative insulin sensitivity in laparoscopic colectomy: a randomized controlled trial. Ann Surg 2020;271(5):819-826. DOI
- Mata J*, Pecorelli N, Kaneva P, Moldoveanu D, Gosselin-Tardiff A, Alhashemi M, Robitaille S, Balvardi S, Lee L, Stein BL, Liberman S, Charlebois P, Fiore JF Jr, Feldman LS. A mobile device application (app) to improve adherence to an enhanced recovery program for colorectal surgery: a randomized controlled trial. Surg Endosc 2020; 34 (2), 742-751. DOI
- Dumitra TC, Trepanier M, Fiore JF Jr, Kaneva P, Carli F, Fried GM, Feldman LS, Lee L. The relationship of two postoperative complication grading schemas with postoperative quality of life after elective colorectal surgery. Surgery 2019; 166 (4), 663-669. DOI
- Sorial RK, Ali M, Kaneva P, Fiore JF Jr, Vassiliou M, Fried GM, Feldman LS, Ferri LE, Lee L, Mueller CL. Modern era surgical outcomes of elective and emergency giant paraesophageal hernia repair at a high-volume referral center. Surg Endosc 2019; 34 (1), 284-289. DOI
- Pecorelli N*, Balvardi S, Liberman AS, Charlebois P, Stein B, Carli F, Feldman LS, Fiore JF Jr. Does adherence to perioperative enhanced recovery pathway elements influence patient-reported recovery following colorectal resection? Surg Endosc 2019; 33 (11), 3806-3815. DOI
- Balvardi S*, Castelino T, Pecorelli N, Niculiseanu P, Liberman S, Charlebois P, Stein B, Carli F, Mayo N, Feldman LS, Fiore JF Jr. Construct validity and responsiveness of the Abdominal Surgery Impact Scale in the context of recovery after colorectal surgery. Dis Colon Rectum 2019; 62(3):309-317. DOI
- Alhashemi M*, Fiore JF Jr, Safa N, Al Mahroos M, Mata J, Pecorelli N, Baldini G, Dendukuri N, Stein BL, Liberman AS, Charlebois P, Carli F, Feldman LS. Incidence and predictors of prolonged postoperative ileus after colorectal surgery in the context of an enhanced recovery pathway. Surg Endosc 2019; 33(7):2313-2322. DOI
- Balvardi S*, Castelino T, Pecorelli N, Niculiseanu P, Hershorn O, Liberman S, Charlebois P, Stein B, Carli F, Mayo N, Feldman LS, Fiore JF Jr. Measuring in-hospital recovery after colorectal surgery: A comparison between hospital length of stay and time to readiness for discharge. Dis Colon Rectum 2018; 61(7):854-860. DOI