Comparison of Early Mobilization and Diet Rehabilitation Program With Conventional Care After Laparoscopic Colon Surgery: A Prospective Randomized Controlled Trial

Abstract

A rehabilitation program with early mobilization and diet after laparoscopic colon surgery results in reduced recovery time without increased complications. These results suggest that a multimodal rehabilitation program may increase the short-term benefits after laparoscopic colon surgery.

Comparison of anastomotic configuration after laparoscopic right hemicolectomy under enhanced recovery program: side-to-side versus end-to-side anastomosis

“…In Korea, the hospital stay can be prolonged by the patient's refusal to be discharged, which arises because the financial burden on the patient is low under Korea's national health insurance system [10]. In this study, the recovery times of the two groups did not differ.…”

“…On the same day, the PCA line and urinary catheter were removed, and the patients were encouraged to take ambulate at least 600 m about the ward. Ambulation for of 600 m without assistance was one of the criteria for recovery time in our previous study [10]. However, in the present study, this item was not available in the database for limitation of retrospective study.…”

“…Although our results favor the E-S configuration for ileocolic anastomosis based on the higher recovery rate, shortened hospital stay, and lower overall complication rate, more evidence is required to confirm the superiority of the E-S configuration. Second, the recovery time estimated here was not as precise as in our previous randomized controlled studies because the study was retrospective [10,11]. In the present study, the patient's safe ambulation was not included in the recovery criteria, which is one of the recovery criteria used in our previous studies.…”

“…Since October 2009, this protocol has been applied to all patients who have undergone laparoscopic colon surgery. We reported the efficacy of this protocol after laparoscopic colonic resection in a previous study [10]. Two days before the operation, the patient underwent bowel preparation with a polyethylene glycol 3350 electrolyte solution.…”

“…The recovery time, recovery rate, and the length of hospital stay were compared between the two groups to analyze the patients' recovery after surgery. Recovery time, which was a surrogate marker for postoperative recovery [10,11], was defined as the time (hours) at which all of the following three criteria were met: (1) tolerated diet: able to eat a third or more of a soft-blend meal with no abdominal discomfort for 24 h; (2) no analgesia: no intravenous or oral analgesic drug was necessary after the cessation of patient-controlled anesthesia (PCA); and (3) afebrile status: afebrile status (fever was defined as a body temperature exceeding 37.2°C at the axilla) without complications. The recovery rate was defined as the rate at which the patient satisfied all these criteria.…”