Enhanced recovery after surgery versus conventional perioperative care in rectal surgery

Dis Colon Rectum. 2011 Jul;54(7):833-9. doi: 10.1007/DCR.0b013e318216067d.

Abstract

Background: Enhanced recovery after surgery programs have been developed to improve recovery, shorten hospital stays, and reduce morbidity.

Objective: The aim of the current study was to examine the effects of the enhanced recovery program on the outcome of rectal surgery.

Design: A cohort of patients who underwent open rectal surgery after an enhanced recovery program was compared with a historic case-matched control group receiving conventional perioperative care. Patients were matched for type of surgery, disease, comorbidity, and demographic characteristics. Data regarding fast-track targets, length of hospital stay, mortality, complications, relaparotomies, and readmissions were collected.

Results: Forty-one patients in the enhanced recovery group were compared with 82 case-matched patients receiving conventional care. The length of hospital stay (median: 8 days vs 12 days, P < .005) was reduced in the enhanced recovery after surgery group. There were no significant differences in epidural use, mortality, morbidity, and readmission rates between groups.

Limitations: This study performed an intention-to-treat analysis for the multimodal enhanced recovery program in rectal surgery. Specific elements of the program were not analyzed separately. The study used nonrandomly assigned historic controls for comparison.

Conclusion: Enhanced recovery after surgery programs help to reduce the length of hospital stay after rectal surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Colorectal Surgery / rehabilitation*
  • Early Ambulation*
  • Female
  • Humans
  • Length of Stay / trends
  • Male
  • Middle Aged
  • Perioperative Care / methods*
  • Prognosis
  • Rectal Diseases / surgery