[Reducing the hospital stay after colorectal resection].
BACKGROUND
The postoperative hospital stay after colorectal resection is about 15 days in France, when some authors have published a postoperative stay of 2 to 5 days. The aim of this work was to obtain a postoperative hospital stay less than 7 days.


METHODS
Sixty-one patients who underwent a colorectal resection performed by laparotomy were included in the study: 16 right hemicolectomies, 9 left hemicolectomies, 15 sigmoidectomies and 21 anterior resections were performed. The operation was performed through a midline incision extended over the umbilicus in 13 cases, limited below the umbilicus in 22 cases and elective in 26 cases (right transverse in 16 and left iliac fossa in 10 cases). The protocol comprised epidural analgesia or wound infusion with ropivacaine, restricted intravenous fluids, early oral feeding and active mobilisation.


RESULTS
The median and mean times of discharge were 6 and 7.3 days respectively; 36 patients (59%) were discharged on postoperative days 3 to 6, 8 patients (13%) on days 7 and 17 (28%) after day 7. A nasogastric tube was necessary in 2 cases (3.3%). Ten (16%) postoperative complications and 3 (5%) readmissions occurred. There were no deaths.


CONCLUSIONS
Although the postoperative stay cannot be reduced in all the cases, a median hospital stay inferior to which is currently observed can easily be obtained by applying some simple and inexpensive means. This is advantageous for the patient, whose recovery is faster, and contributes to reduce the cost, which is of crucial importance today.
Pélissier
E
E
CAPIO Clinique Saint-Vincent, 40, chemin des Tilleroyes, 25000 Besançon, France. pelissier.edouard@wanadoo.fr
Monek
O
O
Cuche
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000577:Amides / Q000627:therapeutic use; D015360:Analgesia, Epidural; D000779:Anesthetics, Local / Q000627:therapeutic use; D015331:Cohort Studies; D003082:Colectomy / Q000534:rehabilitation*; D003106:Colon / Q000601:surgery*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009068:Movement; D010359:Patient Readmission; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery*; D000077212:Ropivacaine; D014945:Wound Healing
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine