Effect of a clinical pathway after laparoscopic surgery for colorectal cancer.
OBJECTIVE
The purpose of this study was to evaluate whether implementation of a clinical pathway (CP) reduces length of stay after laparoscopic surgery for colorectal carcinoma.


METHODS
We retrospectively reviewed 330 patients with colorectal carcinoma who underwent laparoscopic surgery between 2002 and 2006. The patients were divided into 2 groups: no clinical pathway patients in 2002-03 (Group A) and those managed with clinical pathway in 2004-06 (Group B). Patients in Group B were planned to be discharged and return home within postoperative day 8, with use of CP.


RESULTS
There was no mortality in either group. In Group B, the rate of patients who started solid food within postoperative day 3 was significantly higher than in Group A for both colon carcinoma (96.7 vs. 82.8%, p = 0.001) and rectal carcinoma (94.2 vs. 65.5%, p = 0.001). The rate of patients discharged within postoperative day 8 was significantly higher in Group B than in Group A (98.5 vs. 64.8%, p = 0.001), although there were more advanced cases in Group B.


CONCLUSIONS
The implementation of clinical pathway has led to the standardization of patient care and considerable decrease in length of stay after laparoscopic surgery for colorectal carcinoma.
Ishiguro
Seiji
S
Colorectal Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji Tyuo-ku, Tokyo 104-0045, Japan.
Yamamoto
Seiichiro
S
Fujita
Shin
S
Akasu
Takayuki
T
Kobayashi
Yutaka
Y
Moriya
Yoshihiro
Y
D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003082:Colectomy; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D019091:Critical Pathways; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome