title: The benefit of an enhanced recovery programme following elective laparoscopic sigmoid colectomy.
abstract: BACKGROUND
  Enhanced recovery programmes (ERPs) have demonstrated reduced morbidity and length of hospital stay in patients undergoing open elective colorectal resections. The application of laparoscopic techniques to colorectal surgery is associated with shorter length of stay and morbidity compared to open resections. In the setting of laparoscopic surgery, it is unclear whether there is an additive effect on length of stay and morbidity by combining these. The current study addresses the benefit of an ERP (RAPID protocol) in a cohort of matched patients undergoing laparoscopic sigmoid colon resection
  
  
  METHODS
  Consecutive patients over a 40-month period who underwent laparoscopic sigmoid colon resection were assigned either to the RAPID protocol (group 1) or traditional post operative care (group 2) in a non-randomised manner. Analysis was on an "intention to treat" basis. Primary and secondary endpoints were identified; primary endpoints included length of hospital stay and readmission rate. Secondary endpoints included morbidity and mortality rate.
  
  
  RESULTS
  Seventy-three consecutive patients were included. Group 1 included 37 patients. Group 2 included 36 patients. Median length of hospital stay in groups 1 and 2 was 5 and 8 days, respectively (p = 0.01). Readmission rate in groups 1 and 2 was 8.1% and 8.3%, respectively (p = 0.98). Morbidity rate in groups 1 and 2 was 30% and 22%, respectively (p = 0.61); there was one mortality in each group.
  
  
  CONCLUSIONS
  The application of the ERP (RAPID) to patients undergoing laparoscopic sigmoid colon resection results in a significant improvement in length of hospital stay, with comparable morbidity and readmission rates.
authors.affiliation: Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Tallaght, Dublin 24, Ireland.
authors.forename: Hasan
authors.initials: H
authors.lastname: Al Chalabi
authors.forename: Dara O
authors.initials: DO
authors.lastname: Kavanagh
authors.forename: Lana
authors.initials: L
authors.lastname: Hassan
authors.forename: Kate O
authors.initials: KO
authors.lastname: Donnell
authors.forename: Emmeline
authors.initials: E
authors.lastname: Nugent
authors.forename: Emmet
authors.initials: E
authors.lastname: Andrews
authors.forename: Frank B V
authors.initials: FB
authors.lastname: Keane
authors.forename: Diarmuid S
authors.initials: DS
authors.lastname: O'Riordain
authors.forename: Andrew
authors.initials: A
authors.lastname: Miller
authors.forename: Paul
authors.initials: P
authors.lastname: Neary
mesh_terms: D003082:Colectomy / Q000379:methods* / Q000401:mortality; D012809:Colon, Sigmoid / Q000473:pathology / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000401:mortality; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D020127:Recovery of Function