Premium
Enhanced recovery after surgery versus conventional care in colonic and rectal surgery
Author(s) -
Keane Celia,
Savage Stephanie,
McFarlane Kim,
Seigne Richard,
Robertson Greg,
Eglinton Tim
Publication year - 2012
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06139.x
Subject(s) - medicine , perioperative , colorectal surgery , complication , elective surgery , surgery , retrospective cohort study , general surgery , abdominal surgery
Enhanced recovery after surgery ( ERAS ) programmes have been shown to improve outcomes after colonic surgery. However, there is less evidence supporting ERAS in rectal surgery. The aim of this study was to compare outcomes of conventional perioperative care with those of an ERAS pathway including both colonic and rectal surgery patients. Methods Outcomes of patients undergoing elective colorectal surgery at C hristchurch H ospital within the ERAS pathway were compared with patients receiving conventional perioperative care over a 2‐year period. A retrospective analysis was conducted, including primary and total length of stay ( LOS ), readmission, complication and mortality rate. Results A total of 240 patients undergoing colorectal surgery were included; 160 patients received conventional perioperative care and 80 patients were managed within the ERAS pathway. Primary and total LOS were shorter in the ERAS group (6 versus 7 days, P = 0.0004, 7 versus 10 days, P = 0.0003, respectively). Re‐admission and complication rates were not significantly different between the groups. There was one death (in the conventional care group) within 30 days. Patients undergoing rectal surgery within the ERAS pathway did not show any difference in primary LOS , readmission or complication rate although median total LOS was significantly reduced (7 versus 10 days, P = 0.0457). Conclusion Patients undergoing elective colorectal surgery managed within the ERAS pathway had shorter hospital stays without increased morbidity or mortality. Differences were less pronounced in the rectal surgery subgroup and further research is needed to investigate the use of ERAS pathways for patients undergoing elective rectal surgery.