An enhanced recovery programme reduces length of stay after rectal surgery

Abstract

Patients having rectal resections benefit from a multimodal approach to surgery with significant reductions in LOS, but no change in morbidity or mortality.

Enhanced recovery after surgery versus conventional care in colonic and rectal surgery

“…2 Three of the four RCTs reported a statistically significant shorter primary hospital stay. 11,16,25 The only one of these studies, which utilized a control group, found a significant reduction in hospital stay in the ERAS patients. 12 Pooled analysis of readmission, minor complications, major complications and mortality showed no difference.…”

“…6,23,24 In the remaining study, patients in the ERAS group were significantly older than patients in the control group. 11 The very modest benefit demonstrated for rectal surgery patients in this pathway reflects the different post-operative requirements of this group. 2 However, pooled analysis for total complications showed a reduced relative risk of developing complications in the ERAS group (RR 0.61, 95% CI = 0.42-0.88).…”

“…2,3,5,10,11,29,30 Studies to investigate whether there is an additional advantage of using laparoscopic surgery within an ERAS pathway, have produced inconsistent results. Laparoscopic colorectal surgery has been shown to be associated with shorter hospital stays both independently and within ERAS programmes.…”

“…[1][2][3][4]9,[11][12][13][14][15][16] Meta-analyses pooling data from randomized and controlled clinical trials suggest enhanced recovery programmes reduce primary stay by 1.56-2.35 days and total stay by 2.46 days. [1][2][3][4]9,[11][12][13][14][15][16] Meta-analyses pooling data from randomized and controlled clinical trials suggest enhanced recovery programmes reduce primary stay by 1.56-2.35 days and total stay by 2.46 days.…”

Postoperative morbidity after fast‐track laparoscopic resection of rectal cancer

“…However, it is far from being free of complications. As fast‐track recovery programmes have had a dramatic effect on perioperative outcomes in colorectal surgery [4] it might be expected that rectal cancer patients would benefit substantially from a combination of laparoscopic surgery and a fast‐track programme [5] regarding medical complications and surgical complications [6].…”