An enhanced recovery programme reduces length of stay after rectal surgery.
OBJECTIVE
Enhanced Recovery Programmes (ERP) result in shorter hospital stay after colonic resection with no increase in complication, mortality or readmission rates. There is little data regarding the use of an ERP after rectal resection. We investigated the effect of introducing laparoscopic surgery and the ERP on outcomes in our unit.


METHODS
From February 2007, elective patients undergoing rectal resection (laparoscopic or open) under the care of two colorectal surgeons were placed into the ERP. Length of stay (LOS) was recorded as total LOS, including readmissions. Comparison was made with a cohort of patients from 2004-2005 before the onset of laparoscopic surgery/ERP.


RESULTS
Forty patients in the ERP group were compared with 42 patients from 2004-2005. Morbidity and mortality rates were similar. LOS was shorter in the ERP group cf. the retrospective group (median 7 days vs. 11 days; p=0.002). Median LOS was shorter in both laparoscopic ERP patients (6 days cf. 11 days; p= 0.004) and open ERP patients (7 days cf. 11 days; p=0.014) cf. the retrospective group.


CONCLUSIONS
Patients having rectal resections benefit from a multimodal approach to surgery with significant reductions in LOS, but no change in morbidity or mortality.
Branagan
Graham
G
Department of Surgery, Salisbury NHS Foundation Trust, Odstock, Salisbury, Wilts, UK. gbr1911@yahoo.co.uk
Richardson
Lynn
L
Shetty
Archana
A
Chave
Helen S
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D010351:Patient Discharge; D020127:Recovery of Function / Q000502:physiology*; D012007:Rectum / Q000503:physiopathology* / Q000601:surgery*