title: Two-day hospital stay after laparoscopic colorectal surgery under an enhanced recovery after surgery (ERAS) pathway.
abstract: BACKGROUND
  The present study aims to examine the feasibility and safety of a two-day hospital stay after laparoscopic colorectal resection (LCR) under an enhanced recovery after surgery (ERAS) pathway.
  
  
  METHODS
  Between 2003 and 2010, 882 consecutive patients undergoing LCR were analyzed. Patients were grouped and analyzed according to whether their hospital stay was 2 days (group A) or longer (group B). Demographic, surgical, and postoperative data were compared. To identify independent predictive factors related to a short hospital stay, a multivariate analysis was also performed.
  
  
  RESULTS
  Group A represented 10.3 % of this series (91 patients). There were no differences regarding age, gender, BMI, ASA, and previous abdominal surgeries between groups. Group A had a lower incidence of rectal cancer and anterior resections than group B (6.6 vs. 17.7 % [p = 0.006] and 14.3 vs. 23.4 % [p = 0.048]), respectively, and a lower mean operative time (170 min vs. 192 min; p = 0.002). Group A had a lower overall morbidity rate than group B (5.5 vs. 16.9 %; p = 0.004) and a lower incidence of surgery-related complications (5.5 vs. 14.9 %; p = 0.001). The overall conversion rate was 10 % (only one patient in group A required conversion), and the difference in conversion rate between groups was statistically significant (1.2 vs. 10.7 %; p = 0.003). Group A had a lower readmission rate (0 vs. 4.9 %; p = 0.089). Multivariate analysis showed that conversion, postoperative morbidity, and rectal prolapse were independently associated with the length of hospital stay.
  
  
  CONCLUSIONS
  A two-day hospital stay after LCR is safe and feasible under an ERAS pathway, without compromising the readmission or complication rate.
authors.affiliation: Section of Colorectal Surgery, Service of General Surgery, Hospital Italiano de Buenos Aires, 450 Gascón st, 1181 Buenos Aires, Argentina. gustavo.rossi@hospitalitaliano.org.ar
authors.forename: Gustavo
authors.initials: G
authors.lastname: Rossi
authors.forename: Hernán
authors.initials: H
authors.lastname: Vaccarezza
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Vaccaro
authors.forename: Ricardo E
authors.initials: RE
authors.lastname: Mentz
authors.forename: Victor
authors.initials: V
authors.lastname: Im
authors.forename: Adrián
authors.initials: A
authors.lastname: Alvarez
authors.forename: Guillermo Ojea
authors.initials: GO
authors.lastname: Quintana
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods / Q000534:rehabilitation*; D003108:Colonic Diseases / Q000601:surgery*; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D019091:Critical Pathways; D003661:Decision Support Techniques; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D010535:Laparoscopy / Q000534:rehabilitation*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D010359:Patient Readmission / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D012044:Regression Analysis; D012307:Risk Factors; D016896:Treatment Outcome