title: Successful enhanced recovery program after colorectal surgery in a county institution.
abstract: 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.
authors.affiliation: Harbor-UCLA Medical Center, Torrance, California, USA.
authors.forename: Armen
authors.initials: A
authors.lastname: Aboulian
authors.forename: Zailani
authors.initials: Z
authors.lastname: Hassan
authors.forename: Matthew Y C
authors.initials: MY
authors.lastname: Lin
authors.forename: Amy H
authors.initials: AH
authors.lastname: Kaji
authors.forename: Ravin R
authors.initials: RR
authors.lastname: Kumar
mesh_terms: D000328:Adult; D002140:California; D003082:Colectomy / Q000534:rehabilitation*; D003108:Colonic Diseases / Q000601:surgery*; D019091:Critical Pathways / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006766:Hospitals, County; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D011182:Postoperative Care / Q000379:methods; D020127:Recovery of Function; D012002:Rectal Diseases / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data