Environmental impact of the enhanced recovery pathway in colorectal surgery: A simulation study.

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Colorectal Disease Pub Date : 2024-11-20 DOI:10.1111/codi.17247

Karem Slim, Julie Veziant, Audrey Enguix, Laurent Zieleskiewicz

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引用次数: 0

Abstract

Aim: Most of the literature on the environmental impact of surgery has analysed operating theatre practice in terms of its contribution to global warming (by greenhouse gas effects). The aim of this study was to assess the overall environmental impact of a complete perioperative pathway with and without implementation of an enhanced recovery programme (ERP).

Method: We compared two scenarios: an ERP scenario and a conventional scenario (CONV) for colorectal surgery. We carried out a lifecycle analysis for perioperative procedures, devices and consumables. We measured the impact on 17 environmental variables in addition to global warming.

Results: The overall environmental impact of ERP was 6% lower than that of conventional care. The reduction of impact due to ERP ranged from 5% for greenhouse gas emissions (18 kg CO₂ equivalent less per intervention) to 27% for water consumption (3 m³ less). The stages that had the most impact on the environment were the preoperative stage (essentially owing to patient travel) and the intraoperative stage with the surgical part (medical devices representing 83.3% of the impact of the procedure) and the anaesthesia part (halogenated gases and ventilation representing 54.9% of the impact of anaesthesia care).

Conclusion: This study found an ERP approach to be more eco-responsible than conventional care. This is an additional benefit of ERP implementation. The impact of ERP implementation might be further reduced by action on the preoperative and intraoperative stages.

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结直肠手术中强化恢复路径对环境的影响：模拟研究。

目的：大多数关于外科手术对环境影响的文献都是从其对全球变暖的贡献（温室气体效应）角度分析手术室实践的。本研究旨在评估实施和未实施强化恢复计划（ERP）的完整围手术期路径对环境的总体影响：我们比较了两种方案：ERP 方案和传统的结直肠手术方案 (CONV)。我们对围手术过程、设备和耗材进行了生命周期分析。除全球变暖外，我们还测量了对 17 个环境变量的影响：结果：ERP 对环境的总体影响比传统护理低 6%。ERP减少的影响从温室气体排放的5%（每次干预减少18千克二氧化碳当量）到用水量的27%（减少3立方米）不等。对环境影响最大的阶段是术前阶段（主要是由于患者的旅行）和术中阶段，其中手术部分（医疗设备占手术影响的 83.3%）和麻醉部分（卤化气体和通风占麻醉护理影响的 54.9%）：这项研究发现，与传统护理相比，ERP 方法对生态环境更负责任。这是实施ERP的额外好处。通过在术前和术中阶段采取行动，可能会进一步减少实施企业资源规划的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.