Preoperative factors prolonging the length of stay in elective colorectal surgery

2010 ◽  
Vol 81 (9) ◽  
pp. 624-628 ◽  
Author(s):  
Nicholas K. Ngui ◽  
Kerry Hitos ◽  
Grahame Ctercteko
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Elective Colorectal Surgery ◽  
Preoperative Factors

scholarly journals Another Brick in the Wall of an Ongoing Discussion– Reduction of Anastomotic Leaks after Colorectal Resection by Preoperative Mechanical Bowel Preparation in Combination with Oral and Parenteral Antibiotics?–A Clinical Retrospective Single Center Study

2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Safia O ◽  
◽  
Kuebler S ◽  
Mall JW ◽  
Tallbot SR ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Bowel Preparation ◽  
Elective Surgery ◽  
Mechanical Bowel Preparation ◽  
Oral Antibiotic ◽  
Single Center ◽  
Elective Colorectal Surgery ◽  
Single Center Study ◽  
Center Study

Background: In colorectal surgery, postoperative Anastomotic Leak (AL) is a serious complication. Besides the surgeon`s experience, bowel preparation may have an impact on AL, but the published data are still inconclusive. The purpose of this retrospective single center study was to investigate the role of preoperative Mechanical Bowel Preparation (MBP) in combination with Oral Antibiotic Bowel Preparation (OBP) and parenteral antibiotics in a certified highvolume colorectal center. Methods: In the period of January 2017 to December 2019, all colon and rectal surgeries were recorded and separated into emergency and elective surgeries. Patients in the elective surgery group were further divided into two groups: patients with Bowel Preparation (BP) and patients without BP and were evaluated concerning to AL, postoperative hospital length of stay and mortality. Results: Between 2017 to 2019, 625 patients underwent colorectal surgery. 262 patients had emergency operations and were therefore excluded from the study. 363 patients underwent colorectal elective surgery (197men, 166 women). 44.0% received Combined Bowel Preparation (CBP), 46.8% received no BP, 3.3% received OBP only, 4.1% received MBP only, and for 1.1% nothing was documented. CBP was not only associated with a reduction in the rate of AL (P=0.038) (14.1% vs. 4.4%), but also with reduction in mortality (P=0.032) (7.6% vs. 1.2%) and length of stay (P=0.016) (14 vs. 11 days). Conclusion: Our retrospective data showed a significant impact of preoperative intestinal preparation with MBP in combination with OBP and parenteral antibiotics on AL, length of stay and mortality. Therefore we strongly recommend the use of this regimen of preoperative BP in elective colorectal surgery.

Implementation of ERAS protocol in elective colorectal surgery results in reduction in length of stay; discharge within 48 hours is feasible and safe

2019 ◽  
Vol 45 (2) ◽  
pp. e50
Author(s):  
B. Van Den Hengel ◽  
H. Smid-Nanninga ◽  
A.F.T. Olieman ◽  
L.S. Wagenaar ◽  
W. Kelder ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Elective Colorectal Surgery ◽  
Eras Protocol

scholarly journals Reduced length of stay after elective colorectal surgery during the peak phase of Covid-19 pandemic: a positive effect of infection risk awareness?

Surgery ◽  
2020 ◽  
Author(s):  
Antonino Spinelli ◽  
Michele Carvello ◽  
Francesco Maria Carrano ◽  
Francesco Pasini ◽  
Caterina Foppa ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Infection Risk ◽  
Risk Awareness ◽  
Elective Colorectal Surgery ◽  
Positive Effect ◽  
Peak Phase

Laparoscopic approach and patient length of stay in elective colorectal surgery without an enhanced recovery programme

2014 ◽  
Vol 84 (7-8) ◽  
pp. 502-503 ◽  
Author(s):  
Irshad Shaikh ◽  
Mohammed Boshnaq ◽  
Nusrat Iqbal ◽  
Sudhakar Mangam ◽  
George Tsavellas
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Enhanced Recovery ◽  
Laparoscopic Approach ◽  
Elective Colorectal Surgery ◽  
Enhanced Recovery Programme

scholarly journals Limited preoperative physical capacity continues to be associated with poor postoperative outcomes within a colorectal ERAS programme

2019 ◽  
Vol 101 (4) ◽  
pp. 261-267 ◽  
Author(s):  
E McLennan ◽  
R Oliphant ◽  
SJ Moug
Keyword(s):  
Multivariate Analysis ◽  
Postoperative Complications ◽  
Colorectal Surgery ◽  
Length Of Stay ◽  
Hospital Stay ◽  
Patient Outcomes ◽  
Univariate Analysis ◽  
Lifestyle Factors ◽  
Physical Capacity ◽  
Elective Colorectal Surgery

Aim Enhanced recovery after surgery (ERAS) programmes aim to standardise perioperative care leading to optimal patient outcomes. Despite these programmes, variation in outcomes still persists. This study aimed to assess the influence of lifestyle factors on short-term outcomes after colorectal surgery within this optimal recovery programme. Methods Consecutive patients enrolled on an ERAS pathway who underwent elective colorectal surgery (June 2013 to July 2014) at one site were included. We used data routinely collected by ERAS nurse specialists and during preassessment to analyse association between patient and lifestyle factors and likelihood of developing postoperative complications or having an increased length of stay. Results A total of 199 patients were included: mean age 61.8 years (range 17–90 years) and 53.8% male. Age, sex, deprivation, smoking status, alcohol intake, body mass index or level of comorbidity were not associated with postoperative complications. Patients reporting limited preoperative physical capacity (unable to climb two flights of stairs) were more than four times as likely to have a postoperative complication on univariate analysis and were found to still have increased risk of postoperative complications on multivariate analysis. Patients reporting limited preoperative physical capacity were shown to have significantly longer hospital stay on univariate analysis. In the multivariate analysis, limited physical capacity was not associated with prolonged length of stay due to confounding factors of age and deprivation. Conclusions Limited physical capacity was the only patient and lifestyle factor associated with poorer postoperative complications and prolonged hospital stay after elective colorectal surgery within an ERAS programme. Consideration should be given to individualised prehabilitation that aims to increase physical capacity pre-operatively to improve patient outcomes.

scholarly journals ERAS® Program in a Portuguese Hospital: Results from Elective Colorectal Surgery after One Year of Implementation

2020 ◽  
Vol 33 (9) ◽  
pp. 568
Author(s):  
André Carrão ◽  
Daniel Ribeiro ◽  
Maria Manso ◽  
Joana Oliveira ◽  
Luís Féria ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Bowel Function ◽  
Control Group ◽  
Elective Colorectal Surgery ◽  
Improve Patient

Introduction: The Enhanced Recovery After Surgery® program comprises the implementation of various perioperative measures that reduce surgical stress and ultimately improve patient recovery and outcome. The purpose of this study is to evaluate the first-year compliance and clinical outcomes after implementation of the Enhanced Recovery After Surgery® program in elective colorectal surgery in our hospital.Material and Methods: An analysis was performed on the 210 patients who underwent elective colorectal surgery from May 2016 to December 2017. The group of patients that underwent surgery after the protocol implementation (Enhanced Recovery After Surgery® group) was compared to a conventional care control group (pre- Enhanced Recovery After Surgery® group). Differences between the two groups were adjusted using Propensity Score matching. The main outcomes were length of stay, return of bowel function, complications and mortality. The evolution of compliance with Enhanced Recovery After Surgery® principles was also analyzed.Results: After propensity score matching, 112 patients were included in the present study: 56 patients formed the pre-Enhanced Recovery After Surgery® group and 56 the Enhanced Recovery After Surgery® group. The overall adherence to the protocol increased from 35.7% to 80.8%. There was a decrease in length of stay, time to return of bowel function and medical complications.Discussion: The Enhanced Recovery After Surgery® program is safe and seems to shorten length of stay and improve patient recovery and clinical outcome.Conclusion: This study showed that the implementation of the Enhanced Recovery After Surgery® program was possible in Hospital Beatriz Ângelo, with a positive impact in the immediate postoperative recovery of colorectal patients.

scholarly journals Effectiveness and safety of the enhanced recovery program in colorectal surgery: overview of systematic reviews

2020 ◽  
Author(s):  
Kelly Rocío Chacón Acevedo ◽  
Édgar Cortés Reyes ◽  
Óscar Alexander Guevara Cruz ◽  
Jorge Augusto Díaz Rojas ◽  
Lina María Rincón Martínez
Keyword(s):  
Colorectal Surgery ◽  
Length Of Stay ◽  
Systematic Reviews ◽  
Perioperative Care ◽  
Enhanced Recovery ◽  
Hospital Length ◽  
The Body ◽  
Hospital Length Of Stay ◽  
Secondary Outcome ◽  
Elective Colorectal Surgery

Introduction: Multimodal enhanced recovery programs are a new paradigm in perioperative care. Objective: To evaluate the certainty of evidence pertaining to the effectiveness and safety of the multimodal perioperative care program in elective colorectal surgery. Data source: A search was conducted in the Medline, EMBASE, and Cochrane databases, up until February 2020. Eligibility criteria: Systematic reviews that take into account the perioperative multimodal program in patients with an indication for colorectal surgery were included. The primary outcomes were morbidity and postoperative deaths. The secondary outcome was hospital length of stay. Study quality and synthesis method: The reviews were evaluated with AMSTAR-2 and the certainty of the evidence with the GRADE methodology. The findings are presented with measures of frequency, risk estimators, or differences. Results: Six systematic reviews of clinical trials with medium and high quality in AMSTAR-2 were included. Morbidity was reduced between 16 and 48%. Studies are inconclusive regarding postoperative mortality. Hospital length of stay was reduced by an average of 2.5 days (p <0.05). The certainty of the body of evidence is very low. Limitations: The effect of the program, depending on the combination of elements, is not clear. Conclusions and implications: Despite the proven evidence that the program is effective in reducing global postoperative morbidity and hospital stay, the body of evidence is of very low quality. Consequently, results may change with new evidence and further research is required.

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