Laparoscopic Colon Resections With Discharge Less Than 24 Hours

Dobradin, Andrew; Ganji, Maedeh; Alam, Shaan E.; Kar, Pran M.

doi:10.4293/108680813x13654754535791

Cited by 23 publications

(39 citation statements)

References 12 publications

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“…2 A number of studies have been conducted in order to shorten the hospital stay for patients who received a laparoscopic colectomy. 11 However, the operative time for a laparoscopic colectomy is much longer (approximately 200 minutes) than that of any other laparoscopic surgery such as an appendectomy or a cholecystectomy. Scheer reported that operative time could affect the postoperative complication rate.…”

Section: Discussionmentioning

confidence: 99%

Intravenous Lidocaine for Effective Pain Relief After a Laparoscopic Colectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

Ahn

Kang

Choi

et al. 2015

International Surgery

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A perioperative intravenous lidocaine infusion has been reported to decrease postoperative pain. The goal of this study was to evaluate the effectiveness of intravenous lidocaine in reducing postoperative pain for laparoscopic colectomy patients. Fifty-five patients scheduled for an elective laparoscopic colectomy were randomly assigned to 2 groups. Group L received an intravenous bolus injection of lidocaine 1.5 mg/kg before intubation, followed by 2 mg/kg/h continuous infusion during the operation. Group C received the same dosage of saline at the same time. Postoperative pain was assessed at 2, 4, 8, 12, 24, and 48 hours after surgery by using the visual analog scale (VAS). Fentanyl consumption by patient-controlled plus investigator-controlled rescue administration and the total number of button pushes were measured at 2, 4, 8, 12, 24, and 48 hours after surgery. In addition, C-reactive protein (CRP) levels were checked on the operation day and postoperative days 1, 2, 3, and 5. VAS scores were significantly lower in group L than group C until 24 hours after surgery. Fentanyl consumption was lower in group L than group C until 12 hours after surgery. Moreover, additional fentanyl injections and the total number of button pushes appeared to be lower in group L than group C (P , 0.05). The CRP level tended to be lower in group L than group C, especially on postoperative day1 and 2 and appeared to be statistically significant. The satisfaction score was higher in group L than group C (P ¼ 0.024). Intravenous lidocaine infusion during an operation reduces pain after a laparoscopic colectomy.

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Section: Discussionmentioning

confidence: 99%

Intravenous Lidocaine for Effective Pain Relief After a Laparoscopic Colectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

Ahn

Kang

Choi

et al. 2015

International Surgery

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“…The combination of clinical features and CRP should allow for early discharge on day 3. Earlier discharge is possible and even same day discharge has been described following colorectal surgery [ 701 ]. Whatever day the patient is discharged on, there needs to be a clear contingency plan in the event of poor progress after discharge.…”

Section: Introductionmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

et al. 2021

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Aim There is a requirement for an expansive and up to date review of the management of emergency colorectal conditions seen in adults. The primary objective is to provide detailed evidence‐based guidelines for the target audience of general and colorectal surgeons who are responsible for an adult population and who practise in Great Britain and Ireland. Methods Surgeons who are elected members of the Association of Coloproctology of Great Britain and Ireland Emergency Surgery Subcommittee were invited to contribute various sections to the guidelines. They were directed to produce a pathology‐based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. Each author was asked to provide a set of recommendations which were evidence‐based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after two votes were included in the guidelines. Results All aspects of care (excluding abdominal trauma) for emergency colorectal conditions have been included along with 122 recommendations for management. Conclusion These guidelines provide an up to date and evidence‐based summary of the current surgical knowledge in the management of emergency colorectal conditions and should serve as practical text for clinicians managing colorectal conditions in the emergency setting.

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“…Our experience demonstrated a significant progressive reduction of LOS with increasing confidence with the ER protocol from 2013 to 2017. This trend allows us to preconize that within few years most of our patients could be possibly discharged within 24 h [ 18 ]. The implementation of the ER programme with reduced length of stay did not increase morbidity and readmission rate.…”

Section: Discussionmentioning

confidence: 99%

The impact of complications on a programme of enhanced recovery in colorectal surgery

Tebala

Gallucci²,

Khan³

2018

BMC Surg

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BackgroundThe advantages of Enhanced Recovery (ER) programmes are well known, in terms of improved overall experience of the patients, which associates with low morbidity and reduced length of stay. As a result, the pattern of morbidity is changing and some patients may develop complications after discharge. Aim of this work was to evaluate the impact of morbidity and related outcomes such as unplanned readmission and reoperation rate on an ER programme in colorectal surgery.MethodsProspectively collected clinical data of patients who underwent colorectal resection have been retrospectively analysed. Endpoints were: 90-day mortality and morbidity, length of hospital stay (LOS) and rate of unplanned readmissions and reoperations.ResultsMortality and morbidity did not change in the analysed period, but LOS reduced significantly. Main determinant of postoperative LOS was the type of surgical approach, laparoscopy being associated with earlier discharge. LOS was longer in patients who developed complications. Morbidity and reoperation rate were significantly higher in patients discharged after day 4. Majority of complications happened in patients who were still in the hospital. However, the few patients who developed complications after discharge did not have a worse outcome if compared to those who had complications in hospital.ConclusionsER protocols must become integral part of the perioperative management of colorectal patients. ER and laparoscopy have a synergic effect to improve the postoperative recovery and reduce morbidity. Early discharge of patients does not affect the outcome of postoperative complications.

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Laparoscopic Colon Resections With Discharge Less Than 24 Hours

Abstract: Laparoscopic colon surgery that incorporates multimodal perioperative care may allow patients to be discharged within the first 24 hours.

Cited by 23 publications

References 12 publications

Intravenous Lidocaine for Effective Pain Relief After a Laparoscopic Colectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

Intravenous Lidocaine for Effective Pain Relief After a Laparoscopic Colectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery

The impact of complications on a programme of enhanced recovery in colorectal surgery

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