Does enhanced recovery reduce postoperative ileus after colorectal surgery?

Abstract

The implementation of and compliance with an ERAS protocol allowed a reduction in the time to GROT. There is a need for a consensual definition of postoperative ileus.

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery

“…[28][29][30] On average, one can expect return of flatus and or bowel movement within one to two days following elective colorectal surgery within an ERP. [31][32][33] Given that most surgeons continue to require the return of bowel function (as evidenced by the passage of flatus) before discharging patients following colorectal surgery, the return of bowel function remains the primary driver of LOS. 34 It is unclear whether the return of bowel function is essential beyond the tolerance of oral intake, as this practice is being challenged by the emergence of outpatient colectomy protocols.…”

Nonsteroidal anti‐inflammatory drugs reduce the time to recovery of gut function after elective colorectal surgery: a systematic review and meta‐analysis

“…A key consideration for this research is whether these results are clinically relevant within a modern ERAS framework of perioperative care. Current evidence suggests that, despite the use of ERAS, POI still occurs in as many as 25–30% of patients after elective colorectal surgery . Venara et al .…”

“…A key consideration for this research is whether these results are clinically relevant within a modern ERAS framework of perioperative care. Current evidence suggests that, despite the use of ERAS, POI still occurs in as many as 25-30% of patients after elective colorectal surgery [48][49][50]. Venara et al [50] recently looked at the expression of COX-2 mRNA in pathology specimens from patients who underwent elective colorectal surgery and found that ERAS patients had significant reductions in COX-2 mRNA expression compared with patients who did not follow an ERAS pathway.…”

Review of the enhanced recovery pathway for children: perioperative anesthetic considerations

“…Length of stay is a key metric affected by the implementation of an ERAS pathway. In colorectal surgery, opioid-sparing analgesia protocols and goaldirected intraoperative fluid management strategies are both associated with a reduction in postoperative ileus, 62,63 the most common reason for prolonged hospitalization after gastrointestinal surgery. 64 With any program that aims to reduce LOS, it is also important to monitor the hospital readmission rate because premature discharge may result in re-hospitalization.…”