Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study

Oh, Heung‐Kwon; Ihn, Myong Hun; Son, Il Tae; Park, Jin Taek; Lee, Jae-Bong; Kim, Duck-Woo; Kang, Sung Bum

doi:10.1007/s00464-015-4302-y

Cited by 31 publications

(15 citation statements)

References 38 publications

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“…Nonetheless, ERAS is reluctantly adopted in actual practice by colorectal units, because the approach requires the surgeon to set up a multi-disciplinary team, which means that the institution must be large enough to support such a team 12,13 . In Korea, only limited experience with ERAS has been reported, and in practice, there had been no institutions that have introduced ERAS as a routine program 14,15 .…”

Section: Discussionmentioning

confidence: 99%

Comparison of the effects of an ERAS program and a single-port laparoscopic surgery on postoperative outcomes of colon cancer patients

Kim

Lee

et al. 2019

Sci Rep

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Advancement of the surgical modality and perioperative care are the two main dimensions for the modern improvement of surgical outcome. The purpose of this study was to compare the effectiveness of the two by using the data from the single-port laparoscopic surgery and the early recovery after surgery (ERAS) program. Patients who underwent elective surgery for primary adenocarcinoma of the colon were divided into three groups and compared: ERAS (multi-port laparoscopic surgery with ERAS perioperative care), Conventional-SILS (single-port surgery with conventional perioperative care), or Conventional-Multi (multi-port laparoscopic surgery with conventional perioperative care). Ninety-one, 83, and 96 patients were registered, respectively. There were no differences among the three groups in baseline characteristics except pathological stage and operation site in colon. Although the ERAS group started a soft diet earlier and had earlier discharge, there were no differences in intra- and post-operative morbidity rate, readmission rate, or reoperation rate. The ERAS perioperative care was a significant factor for reducing length of hospital stay in the multivariate analysis, while single-port surgery was not. In modern laparoscopic colon cancer treatment, a systemic approach such as the ERAS program appears to be more effective than a technical approach for significantly improving short-term surgical outcomes.

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Section: Discussionmentioning

confidence: 99%

Comparison of the effects of an ERAS program and a single-port laparoscopic surgery on postoperative outcomes of colon cancer patients

Kim

Lee

et al. 2019

Sci Rep

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“…Additionally, all enhanced recovery programs rely on optimally performed surgeries. Intraoperative decisions impact outcomes (12). Ambulation refusal may be an early marker of potential complications along with other physiologic parameters.…”

Section: Discussionmentioning

confidence: 99%

Walking to recovery: the effects of missed ambulation events on postsurgical recovery after bowel resection

Stethen

Ghazi

Heidel

et al. 2018

J. Gastrointest. Oncol.

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Background: Early ambulation after surgery is demonstrated to reduce complications and decreases patient length of stay (LOS) as part of an enhanced recovery after surgery (ERAS) program. This study hypothesizes that missed and refused ambulation attempts prolong patient LOS. Methods: From January 2014 to December 2016, all patients admitted to one ward who had undergone bowel resection surgery were assigned a dedicated ambulation team with the goal of ambulating 3 times per day. Clinical data was collected prospectively. Statistical analysis of ambulation frequency, percentage of ambulation sessions completed and overall LOS was performed to test the hypothesis. Results: A total of 127 patients were analyzed for mean age, breakdown of laparoscopic/open procedures/presurgery ambulation status. The median LOS (mLOS) for all patients was 4.3 days. When ambulation was not offered for a 24-hour period, the mLOS increased from 3.6 to 6.6 days (P<0.001). When a patient refused to ambulate at any time, the mLOS increased from 4.0 to 4.7 days (P=0.004). There was a significant association between completed ambulation attempts and mLOS (r=−0.536, P<0.001). Increasing narcotic use (r=0.548, P<0.001) including the use of a patient-controlled analgesia (PCA) (r=0.213, P=0.011) increased mLOS. Conclusions: Ambulation participation is a critical component of an enhanced bowel resection pathway. Non-compliance is associated with an increased LOS. Optimizing pain control, minimizing narcotics, and ensuring adequate ambulation resources also contribute to decreased LOS.

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“…The effectiveness of ERPs is now well established. Nevertheless, in recent years several authors have addressed the failure of enhanced recovery programmes in colorectal surgery [2][3][4][5][6]. In doing so they raise the question of what precisely is meant by failure of an ERP, as the criteria for failure vary markedly in the literature.…”

Section: Dear Editormentioning

confidence: 99%

Failure of enhanced recovery after surgery: what is it?

Slim

Joris

2020

Colorectal Disease

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Factors associated with failure of enhanced recovery programs after laparoscopic colon cancer surgery: a single-center retrospective study

Cited by 31 publications

References 38 publications

Comparison of the effects of an ERAS program and a single-port laparoscopic surgery on postoperative outcomes of colon cancer patients

Comparison of the effects of an ERAS program and a single-port laparoscopic surgery on postoperative outcomes of colon cancer patients

Walking to recovery: the effects of missed ambulation events on postsurgical recovery after bowel resection

Failure of enhanced recovery after surgery: what is it?

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