Impact of surgical indication on patient outcomes and compliance with enhanced recovery program for colorectal surgery: A Francophone multicenter retrospective analysis

Abstract

Background and Objective The impact of surgical indication on compliance with enhanced recovery program (ERP) and on outcomes has never been assessed. This study aims to assess the impact of surgical indication (malignant vs benign) on postoperative outcomes and ERP compliance. Methods A multicenter nationwide database was analyzed. Patients who underwent colorectal surgery for benign disease and those who underwent colorectal surgery for cancer were compared. Inclusion criteria were elective colorectal resection with anastomosis. ERP components, postoperative morbidity, and hospital length of hospital stay data were collected. Results Among the 6472 patients registered in the database between October 2012 and June 2018, 4528 patients were included; 2647 in the malignant group and 1881 in the benign group. The ERP compliance over 70% was not different between groups. Postoperative morbidity rate was higher in the malignant group (22.5% vs 19.3%; P = .009) but not confirmed in multivariate analysis. Patients in the malignant group were more often readmitted after discharge, 6.6% vs 4.6% (P = .004). The mean LOS was 6.3 ± 5.0 days in the malignant group and 5.4 ± 4.7 days in the benign group (P < .001). Conclusions Indication for colorectal surgery did not significantly influence peri‐operative management and postoperative major complications, in patients managed within an enhanced recovery program.

A retrospective study on the efficacy of the ERAS protocol in patients who underwent laparoscopic left and right colectomy surgeries

“…Patients admitted to Chengdu Shang Jin Nan Fu Hospital and West China Hospital from December 2019 to December 2022 who underwent elective colectomy (mainly laparoscopic RC or LC for cancer treatment) were selected and treated according to the standardized ERAS protocol, shown in Figure 1 . Prolonged postoperative ileus (PPOI) was the primary endpoint, and the secondary endpoints was median post-operative stay ( 8 , 9 ). This study involving human participants were reviewed and approved by the ethics committee of Chengdu Shang Jin Nan Fu Hospital (EC20200029), and were conducted according to established ethical guidelines.…”