Case controlled study of the hospital stay and return to full activity following laparoscopic and open colorectal surgery before and after the introduction of an enhanced recovery programme

2009 ◽  
Vol 12 (10) ◽  
pp. 1001-1006 ◽  
Author(s):  
T. M. Raymond ◽  
S. Kumar ◽  
J. K. Dastur ◽  
J. P. Adamek ◽  
U. P. Khot ◽  
...  
2017 ◽  
Vol 3 ◽  
pp. 233372141770629 ◽  
Author(s):  
Håvard Mjørud Forsmo ◽  
Christian Erichsen ◽  
Anne Rasdal ◽  
Hartwig Körner ◽  
Frank Pfeffer

Aim: Enhanced recovery after surgery (ERAS) is a multimodal approach that aims to optimize perioperative treatment. Whether elderly patients receiving colorectal surgery can adhere to and benefit from an ERAS approach is uncertain. The aim of this study was to compare patients in different age groups participating in an ERAS program. Method: In this substudy of a randomized controlled trial, we analyzed the interventional ERAS arm of adult patients eligible for laparoscopic or open colorectal resection with regard to the importance of age. Patients were divided into three groups based on age: ≤65 years ( n = 79), 66-79 years ( n = 56), and ≥80 years ( n = 19). The primary end point was total postoperative hospital stay (THS). Secondary end points were postoperative hospital stay, postoperative complications, postoperative C-reactive protein levels, readmission rate, mortality, and patient adherence to the different ERAS elements. All parameters and measuring the adherence to the ERAS protocol were recorded before surgery, on the day of the operation, and daily until discharge. Results: There were no significant differences in length of THS between age groups (≤65 years, median 5 [range 2-47] days; 66-79 years, median 5.5 [range 2-36] days; ≥80 years, median 7 [range 3-50] days; p = .53). All secondary outcomes were similar between age groups. Patient adherence to the ERAS protocol was as good in the elderly as it was in the younger patients. Conclusion: Elderly patients adhered to and benefited from an ERAS program, similar to their younger counterparts.


2018 ◽  
Vol 118 (2) ◽  
pp. 73-77 ◽  
Author(s):  
Jean Joris ◽  
Daniel Léonard ◽  
Karem Slim

2009 ◽  
Vol 98 (3) ◽  
pp. 155-159 ◽  
Author(s):  
A. C. Miohn ◽  
S. V. Bernardshaw ◽  
S.-M. Ristesund ◽  
P. E. Hovde Hansen ◽  
O. Rœkke

Background and Aims: Enhanced recovery after surgery (ERAS) has reduced the median hospital stay from 8–10 days with traditional peri-operative routines to four days. The aim of the present study was to introduce the principles of ERAS in our hospital and measure the effect on hospital stay, complications and quality of life after discharge from hospital. Material and Methods: 94 consecutive patients, 40 males, 54 females, median age 66 years, were included in a prospective non-randomised observational study at Haukeland University Hospital and Haugesund Hospital from October 2000 until February 2003. After a three-month preparation period, the principles of ERAS were implemented. The results were evaluated with questionnaires and by follow-ups 8–10 and 30 days after surgery. The results were compared to the results of colorectal surgery before introduction of accelerated recovery. Results: 45 (48%) and 73 (78%) patients were discharged within three and five days after surgery with ERAS, compared to zero and seven (5%) patients with traditional recovery. The complication rate with ERAS was 31%, and the readmission rate was 15%. After one week, 57% had resumed their daily activities at home. After 30 days, 65% of the patients had resumed their normal and leisure activities. Conclusion: After a proper preparation period, ERAS principles may be implemented in surgical department, and is followed by a reduced median hospital stay and rapid return to normal daily activities for most patients after colorectal surgery.


2019 ◽  
Vol 37 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Julie Perinel ◽  
Antoine Duclos ◽  
Cecile Payet ◽  
Yves Bouffard ◽  
Jean Christophe Lifante ◽  
...  

Background: Implementation of enhanced recovery after surgery (ERAS) program after pancreatic surgery was associated with decreased length of stay (LOS). However, there were only retrospective uncontrolled before-after study, and care protocols were heterogeneous. We aimed to evaluate the impact of ERAS program on postoperative outcomes after pancreatectomy through a prospective controlled study. Methods: A before/after study with a contemporary control group was undertaken in patients undergoing pancreatectomy. We compared 2 groups: the intervention hospital that implemented ERAS program and the control hospital that performed traditional care; and 2 periods: the preimplementation and the post-implementation period. A difference-in-differences approach was used to evaluate whether implementation of ERAS program was associated with improved LOS and postoperative morbidity. Results: About 97 and 75 patients were included in intervention and control hospital. In multivariate analysis, implementation of ERAS was associated with a significantly shorten LOS (hazard ratio 1.61; 95% CI 1.07–2.44) and higher compliance rate (OR 1.34; 95% CI 1.18–1.53). Difference-in-differences analysis revealed that LOS, morbidity, and readmission did not differ after ERAS implementation. Conclusion: Implementation of ERAS program was safe and effective after pancreatectomy with high compliance rate. LOS was significantly reduced without compromising morbidity


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