title: A systematic review of enhanced recovery protocols in colorectal surgery.
abstract: BACKGROUND
  Colorectal surgery has been associated with a complication rate of 15-20% and mean post-operative inpatient stays of 6-11 days. The principles of enhanced recovery after surgery (ERAS) are well established and have been developed to optimise peri-operative  care and facilitate discharge. The purpose of this systematic review is to present an updated review of peri-operative care in colorectal surgery from the available evidence and ERAS group recommendations.
  
  
  METHODS
  Systematic searches of the PubMed and Embase™ databases and the Cochrane  library were conducted. A hand search of bibliographies of identified studies was conducted to identify any additional articles missed by the initial search strategy.
  
  
  RESULTS
  A total of 59 relevant studies were identified. These included six randomised controlled trials and seven clinical  controlled trials that fulfilled the inclusion criteria. These studies showed reductions in duration of inpatient stays in the ERAS groups compared with more traditional care as well as reductions in morbidity and mortality rates.
  
  
  CONCLUSIONS
  Reviewing the data reveals that ERAS protocols  have a role in reducing post-operative morbidity and result in an accelerated recovery following colorectal surgery. Similarly, both primary and overall hospital stays are reduced significantly. However, the available evidence suggests that ERAS protocols do not reduce hospital readmissions  or mortality. These findings help to confirm that ERAS protocols should now be implemented as the standard approach for peri-operative care in colorectal surgery.
authors: Department of Surgery, Northampton General Hospital, Northampton, UK.
authors: A
authors: A
authors: Rawlinson
authors: P
authors: P
authors: Kang
authors: J
authors: J
authors: Evans
authors: A
authors: A
authors: Khanna
mesh_terms: D002985:Clinical Protocols; D002986:Clinical Trials as Topic; D003106:Colon / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D007902:Length of Stay; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data