{"id":4316,"date":"2015-07-03T15:34:00","date_gmt":"2015-07-03T18:34:00","guid":{"rendered":"https:\/\/revistaabcd.org.br\/?p=4316"},"modified":"2022-11-03T15:49:39","modified_gmt":"2022-11-03T18:49:39","slug":"standardized-clinical-pathways-for-esophagectomy-are-not-a-reality-in-brazil-even-with-a-high-prevalence-of-esophageal-cancer-and-achalasia","status":"publish","type":"post","link":"https:\/\/revistaabcd.org.br\/pt-br\/standardized-clinical-pathways-for-esophagectomy-are-not-a-reality-in-brazil-even-with-a-high-prevalence-of-esophageal-cancer-and-achalasia\/","title":{"rendered":"STANDARDIZED CLINICAL PATHWAYS FOR ESOPHAGECTOMY ARE NOT A REALITY IN BRAZIL, EVEN WITH A HIGH PREVALENCE OF ESOPHAGEAL CANCER AND ACHALASIA"},"content":{"rendered":"<h2 class=\"wp-block-heading\">Background:<\/h2>\n\n\n\n<p>The adoption of standardized protocols and specialized multidisciplinary teams for esophagectomy involve changes in routines with the implantation of expensive clinical practices and deviations from ingrained treatment philosophies.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Aim:<\/h2>\n\n\n\n<p>To evaluate the prevalence of standardized protocols and specialized multidisciplinary teams in S\u00e3o Paulo state, Brazil.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Methods:<\/h2>\n\n\n\n<p>Institutions that routinely perform esophagectomies in S\u00e3o Paulo were contacted and questioned about the work team involved in the procedure and the presence of standardized routines in the preoperatory care.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Results:<\/h2>\n\n\n\n<p>Fifteen centers answered the questionnaire: 10 (67%) public institutions and five (33%) private. There were seven (47%) medical schools, six (40%) with a residency program and two (13%) nonacademic institutions. The mean number of esophagectomies per year was 23. There was a multidisciplinary pre-operative team in nine (60%). There was a multidisciplinary postoperative team in 11 (73%). Early mobilization protocol was adopted in 12 (80%) institutions, early feeding in 13 (87%), routinely epidural in seven (47%), analgesia protocol in seven (47%), hydric restriction in six (40%), early extubation in six (40%), standardized hospitalization time in four (27%) and standardized intensive care time in two (13%).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion:<\/h2>\n\n\n\n<p>The prevalence of standardized protocols and specialized teams is very low in Sao Paulo state, Brazil. The presence of specialized surgeons is a reality and standardized protocols related directly to surgeons have higher frequency than those related to other professionals in the multidisciplinary team.<\/p>","protected":false},"excerpt":{"rendered":"<p>Background: The adoption of standardized protocols and specialized multidisciplinary teams for esophagectomy involve changes in routines with the implantation of expensive clinical practices and deviations from ingrained treatment philosophies. Aim: To evaluate the prevalence of standardized protocols and specialized multidisciplinary teams in S\u00e3o Paulo state, Brazil. Methods: Institutions that routinely perform esophagectomies in S\u00e3o Paulo [&hellip;]<\/p>","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_lmt_disableupdate":"","_lmt_disable":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-4316","post","type-post","status-publish","format-standard","hentry","category-original-article"],"acf":[],"modified_by":"Giovani","_links":{"self":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/4316","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/comments?post=4316"}],"version-history":[{"count":0,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/posts\/4316\/revisions"}],"wp:attachment":[{"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/media?parent=4316"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/categories?post=4316"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/revistaabcd.org.br\/pt-br\/wp-json\/wp\/v2\/tags?post=4316"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}