scholarly journals The Effects of a Standardized Postoperative Enhanced Recovery Program after a Laparoscopic Colorectal Resection in Regard to Patients' Recovery and Clinical Outcomes

2010 ◽  
Vol 26 (3) ◽  
pp. 225 ◽  
Author(s):  
Yong Geul Joh ◽  
Jeong Eun Lee ◽  
Sang Hwa Yoo ◽  
Seung Han Kim ◽  
Geu Young Jeong ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Colorectal Resection ◽  
Enhanced Recovery ◽  
Laparoscopic Colorectal Resection ◽  
Enhanced Recovery Program ◽  
Recovery Program

1245 Enhanced Recovery Program in Colorectal Surgery at Basildon And Thurrock University Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
Salim Chetitah ◽  
S Seraj ◽  
A Robinson ◽  
S Adetoye ◽  
Samer Haque
Keyword(s):  
Multidisciplinary Approach ◽  
Colorectal Resection ◽  
Enhanced Recovery ◽  
University Hospital ◽  
Perioperative Analgesia ◽  
Nice Guideline ◽  
Enhanced Recovery Program ◽  
Prolonged Hospital ◽  
Recovery Program ◽  
Care Costs

Abstract Introduction Enhanced recovery program (ERP) is an integrated multidisciplinary approach that requires participation and commitment from different member of staff, and the patient. This is an evidence-based protocol designed to standardize medical care, improve outcomes, and lower care costs. The aim of this study is to observe how ERP protocol is followed in our institution, and to monitor different outcomes. Data was compared to NICE guideline. Method We reviewed all patients who underwent elective colorectal resection for cancer between June 2018 and May 2019. data was collected retrospectively from patient electronic case notes. We monitored compliance with ERP protocol (NICE), as well as outcomes Results 114 patients were included in our study. We noted that just 35% of patients had intraoperative nasogastric tube. Antibiotics: 74.56%, Catheter 98.24%, PCA 79.82%, Spinal anaesthesia 52.63%, Drain 38.59%. In the post op period, patients were mobilized at 1.89 day (1.27) [mean (SD)], NGT removal: 1.81 day (2.31) Refeeding: 1.36 day (1.01). It has been proven that patients with inadequate perioperative analgesia are more prone to develop ileus, to have a prolonged hospital stay, and have an overall higher mortality (p0.001) Conclusions It seems that there is a room for improvement especially in analgesia and prophylactic antibiotics. Following ERP protocols improves overall outcomes.

Enhanced Recovery Program following Colorectal Resection in the Elderly Patient

2011 ◽  
Vol 36 (2) ◽  
pp. 415-423 ◽  
Author(s):  
Nikhil Pawa ◽  
Paul L. Cathcart ◽  
Tan H. A. Arulampalam ◽  
Matthew G. Tutton ◽  
Roger W. Motson
Keyword(s):  
Elderly Patient ◽  
Colorectal Resection ◽  
Enhanced Recovery ◽  
The Elderly ◽  
Enhanced Recovery Program ◽  
Recovery Program

scholarly journals Impact of Enhanced Recovery Program on Clinical Outcomes after Elective Colorectal Surgery in a Rural Hospital

2021 ◽  
Vol 233 (5) ◽  
pp. e25
Author(s):  
Antonio Pesce ◽  
Mattia Portinari ◽  
Nicolò Fabbri ◽  
Valeria Sciascia ◽  
Lisa Uccellatori Ms ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Clinical Outcomes ◽  
Enhanced Recovery ◽  
Rural Hospital ◽  
Elective Colorectal Surgery ◽  
Enhanced Recovery Program ◽  
Recovery Program

scholarly journals Patients’ refusal as major limitation of early discharge after colorectal resection in an enhanced recovery program

2020 ◽  
Vol 405 (3) ◽  
pp. 337-344 ◽  
Author(s):  
Maxime K. Collard ◽  
Morgan Anyla ◽  
Jérémie H. Lefevre ◽  
Conor Shields ◽  
Anaïs Laforest ◽  
...  
Keyword(s):  
Colorectal Resection ◽  
Enhanced Recovery ◽  
Early Discharge ◽  
Enhanced Recovery Program ◽  
Recovery Program

Successful Enhanced Recovery Program after Colorectal Surgery in a County Institution

2010 ◽  
Vol 76 (10) ◽  
pp. 1158-1162 ◽  
Author(s):  
Armen Aboulian ◽  
Zailani Hassan ◽  
Matthew Y.C. Lin ◽  
Amy H. Kaji ◽  
Ravin R. Kumar
Keyword(s):  
Colorectal Surgery ◽  
Hospital Stay ◽  
Colorectal Resection ◽  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Intravenous Fluids ◽  
Strict Adherence ◽  
Enhanced Recovery Program ◽  
Significant Difference ◽  
Recovery Program

Enhanced recovery programs after colorectal surgery have gained acceptance recently as they have shown a decrease length of hospital stay. However, these pathways require strict adherence to standardized programs with patient education and high compliance. This study was designed to assess the feasibility of such a program in a large county hospital. A retrospective review was performed of 54 consecutive patients who underwent laparoscopic or open segmental colorectal resection without an ostomy. The first 27 patients were treated in a conventional manner, whereas the latter 27 were treated using a protocol promoting early feeding and ambulation with decreased intravenous fluids and narcotic use. There were no baseline differences between the groups, however, there was a significant difference in the patients treated with the enhanced recovery program in terms of less intravenous fluids administered in surgery ( P = 0.001), and over the subsequent 3 days ( P = 0.0017), with a decrease in length of hospital stay of 4 compared with 6 days ( P = 0.003). There were no differences in terms of complication and readmission rates. Based on this study, we conclude that strict adherence to a standard enhanced recovery program was effective in reducing hospital stay in patients undergoing colorectal resection without any increase in complications.

scholarly journals A Protocol is not Enough: Enhanced Recovery Program-Based Care and Clinician Adherence Associated with Shorter Stay After Colorectal Surgery

2020 ◽  
Vol 45 (2) ◽  
pp. 347-355
Author(s):  
Ben E. Byrne ◽  
Omar D. Faiz ◽  
Alex Bottle ◽  
Paul Aylin ◽  
Charles A. Vincent
Keyword(s):  
Factor Analysis ◽  
Colorectal Surgery ◽  
Length Of Stay ◽  
Clinical Outcomes ◽  
Enhanced Recovery ◽  
Care Providers ◽  
Elective Colorectal Surgery ◽  
Enhanced Recovery Program ◽  
Care Protocol ◽  
Recovery Program

Abstract Background Randomised trials have shown an Enhanced Recovery Program (ERP) can shorten stay after colorectal surgery. Previous research has focused on patient compliance neglecting the role of care providers. National data on implementation and adherence to standardised care are lacking. We examined care organisation and delivery including the ERP, and correlated this with clinical outcomes. Methods A cross-sectional questionnaire was administered to surgeons and nurses in August–October 2015. All English National Health Service Trusts providing elective colorectal surgery were invited. Responses frequencies and variation were examined. Exploratory factor analysis was performed to identify underlying features of care. Standardised factor scores were correlated with elective clinical outcomes of length of stay, mortality and readmission rates from 2013–15. Results 218/600 (36.3%) postal responses were received from 84/90 (93.3%) Trusts that agreed to participate. Combined with email responses, 301 surveys were analysed. 281/301 (93.4%) agreed or strongly agreed that they had a standardised, ERP-based care protocol. However, 182/301 (60.5%) indicated all consultants managed post-operative oral intake similarly. After factor analysis, higher hospital average ERP-based care standardisation and clinician adherence score were significantly correlated with reduced length of stay, as well as higher ratings of teamwork and support for complication management. Conclusions Standardised, ERP-based care was near universal, but clinician adherence varied markedly. Units reporting higher levels of clinician adherence achieved the lowest length of stay. Having a protocol is not enough. Careful implementation and adherence by all of the team is vital to achieve the best results.

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