title: Early rehabilitation programs after laparoscopic colorectal surgery: evidence and criticism.
abstract: During the past several decades, early rehabilitation programs for the care of patients with colorectal surgery have gained popularity. Several randomized controlled trials and meta-analyses have confirmed that the implementation of these evidence-based detailed perioperative care protocols is useful for early recovery of patients after colorectal resection. Patients cared for based on these protocols had a rapid recovery of bowel movement, shortened length of hospital stay, and fewer complications compared with traditional care programs. However, most of the previous evidence was obtained from studies of early rehabilitation programs adapted to open colonic resection. Currently, limited evidence exists on the effects of early rehabilitation after laparoscopic rectal resection, although this procedure seems to be associated with a higher morbidity than that reported with traditional care. In this article, we review previous studies and guidelines on early rehabilitation programs in patients undergoing rectal surgery. We investigated the status of early rehabilitation programs in rectal surgery and analyzed the limitations of these studies. We also summarized indications and detailed protocol components of current early rehabilitation programs after rectal surgery, focusing on laparoscopic resection.
authors.affiliation: Duck-Woo Kim, Sung-Bum Kang, Soo-Young Lee, Heung-Kwon Oh, Myung-Hoon In, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea.
authors.forename: Duck-Woo
authors.initials: DW
authors.lastname: Kim
authors.affiliation: Duck-Woo Kim, Sung-Bum Kang, Soo-Young Lee, Heung-Kwon Oh, Myung-Hoon In, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea.
authors.forename: Sung-Bum
authors.initials: SB
authors.lastname: Kang
authors.affiliation: Duck-Woo Kim, Sung-Bum Kang, Soo-Young Lee, Heung-Kwon Oh, Myung-Hoon In, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea.
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Duck-Woo Kim, Sung-Bum Kang, Soo-Young Lee, Heung-Kwon Oh, Myung-Hoon In, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea.
authors.forename: Heung-Kwon
authors.initials: HK
authors.lastname: Oh
authors.affiliation: Duck-Woo Kim, Sung-Bum Kang, Soo-Young Lee, Heung-Kwon Oh, Myung-Hoon In, Department of Surgery, Seoul National University Bundang Hospital, Seongnam 463-707, South Korea.
authors.forename: Myung-Hoon
authors.initials: MH
authors.lastname: In
mesh_terms: D003082:Colectomy / Q000009:adverse effects / Q000534:rehabilitation* / Q000592:standards; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods* / Q000592:standards; D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000534:rehabilitation* / Q000592:standards; D007902:Length of Stay; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D020127:Recovery of Function; D012007:Rectum / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Colorectal cancer; Early rehabilitation; Enhanced recovery after surgery; Fast-track; Laparoscopy; Rectal