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Compliance with enhanced recovery after surgery criteria and preoperative and postoperative counselling reduces length of hospital stay in colorectal surgery: results of a randomized controlled trial

Compliance with enhanced recovery after surgery criteria and preoperative and postoperative... Aim The aim of this randomized clinical trial was to compare patients treated using a multimodal approach (enhanced recovery after surgery (ERAS)), with a special focus on counselling, to patients treated in a standard conventional care pathway, who underwent elective colorectal resection. Method In a single‐centre trial, adult patients eligible for open or laparoscopic colorectal resection were randomized to an ERAS programme or standard care. The primary end‐point was postoperative total hospital stay. Identical discharge criteria were defined for both treatment groups. Secondary end‐points included postoperative complications, postoperative C‐reactive protein levels, postoperative hospital stay, readmission rate and mortality. All parameters were recorded before operation, on the day of surgery and daily thereafter until discharge. Results Total hospital stay was significantly shorter among patients randomized to ERAS than among the standard group (median 5 days (range 2–50 days) vs median 8 days (range 2–48 days); P = 0.001). The two treatment groups exhibited similar outcomes regarding overall major and minor morbidity, reoperation rate, readmission rate and 30‐day mortality. There were also no differences in tolerance of enteral nutrition or in the inflammatory response, as reflected by postoperative C‐reactive protein levels. Conclusion ERAS care was associated with a significantly shorter length of hospital stay. Without any difference in surgical or general complications, tolerance of enteral nutrition or postoperative C‐reactive protein levels, peri‐operative information and guidance for ensuring that patients comply with the ERAS approach appear to be important factors to reduce the length of hospital stay. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Colorectal Disease Wiley

Compliance with enhanced recovery after surgery criteria and preoperative and postoperative counselling reduces length of hospital stay in colorectal surgery: results of a randomized controlled trial

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References (26)

Publisher
Wiley
Copyright
Copyright © 2016 The Association of Coloproctology of Great Britain and Ireland
ISSN
1462-8910
eISSN
1463-1318
DOI
10.1111/codi.13253
pmid
27273854
Publisher site
See Article on Publisher Site

Abstract

Aim The aim of this randomized clinical trial was to compare patients treated using a multimodal approach (enhanced recovery after surgery (ERAS)), with a special focus on counselling, to patients treated in a standard conventional care pathway, who underwent elective colorectal resection. Method In a single‐centre trial, adult patients eligible for open or laparoscopic colorectal resection were randomized to an ERAS programme or standard care. The primary end‐point was postoperative total hospital stay. Identical discharge criteria were defined for both treatment groups. Secondary end‐points included postoperative complications, postoperative C‐reactive protein levels, postoperative hospital stay, readmission rate and mortality. All parameters were recorded before operation, on the day of surgery and daily thereafter until discharge. Results Total hospital stay was significantly shorter among patients randomized to ERAS than among the standard group (median 5 days (range 2–50 days) vs median 8 days (range 2–48 days); P = 0.001). The two treatment groups exhibited similar outcomes regarding overall major and minor morbidity, reoperation rate, readmission rate and 30‐day mortality. There were also no differences in tolerance of enteral nutrition or in the inflammatory response, as reflected by postoperative C‐reactive protein levels. Conclusion ERAS care was associated with a significantly shorter length of hospital stay. Without any difference in surgical or general complications, tolerance of enteral nutrition or postoperative C‐reactive protein levels, peri‐operative information and guidance for ensuring that patients comply with the ERAS approach appear to be important factors to reduce the length of hospital stay.

Journal

Colorectal DiseaseWiley

Published: Jun 1, 2016

Keywords: ; ; ;

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