Two‐day Hospital Stay After Laparoscopic Colorectal Surgery under an Enhanced Recovery after Surgery (ERAS) Pathway
Open Access
- 24 July 2013
- journal article
- clinical trial
- Published by Wiley in World Journal of Surgery
- Vol. 37 (10), 2483-2489
- https://doi.org/10.1007/s00268-013-2155-x
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.Keywords
This publication has 24 references indexed in Scilit:
- The enhanced recovery after surgery (ERAS) pathway for patients undergoing colorectal surgery: an update of meta-analysis of randomized controlled trialsInternational Journal of Colorectal Disease, 2012
- Laparoscopic Colorectal SurgeryPublished by American Medical Association (AMA) ,2012
- Conversion in Laparoscopic Colorectal Cancer Surgery: Impact on Short- and Long-Term OutcomeJournal of Laparoendoscopic & Advanced Surgical Techniques, 2011
- Laparoscopy in Combination with Fast Track Multimodal Management is the Best Perioperative Strategy in Patients Undergoing Colonic SurgeryAnnals of Surgery, 2011
- Impact of Conversion on Short and Long-Term Outcome in Laparoscopic Resection of Curable Colorectal CancerJSLS : Journal of the Society of Laparoendoscopic Surgeons, 2011
- Laparoscopic Colorectal Surgery Produces Better Outcomes for High Risk Cancer Patients Compared to Open SurgeryAnnals of Surgery, 2010
- Compliance with enhanced recovery programmes in elective colorectal surgeryBritish Journal of Surgery, 2010
- Conversion from laparoscopic to open colonic cancer resection – Associated factors and their influence on long-term oncological outcomeEuropean Journal of Surgical Oncology, 2009
- 23-Hour-Stay Laparoscopic ColectomyDiseases of the Colon & Rectum, 2009
- Impact of conversion on the long-term outcome in laparoscopic resection of colorectal cancerSurgical Endoscopy, 2008