Key result
Colorectal enhanced recovery programmes minimize metabolic response by reducing routine bowel prep, drains, and fasting.
Enhanced recovery programmes in colorectal surgery aim to minimize morbidity and mortality by reducing the metabolic response to surgery.
May support ERP adoption to minimize metabolic stress in colorectal surgery; leaves open component-specific efficacy.
Since the first successful colorectal resection in 1833 by Reybard of Lyons, surgeons have sought to improve technical and perioperative strategies to minimize morbidity and mortality in colorectal surgery. In the last 10 years, evidence-based medicine has questioned the routine use of mechanical bowel preparation, abdominal drains, nasogastric tubes and prolonged perioperative fasting. A greater understanding of the metabolic response to surgery has led to strategies to minimize the complex cytokine cascades and other neurohumoral factors. These concepts, with attention to social and medical factors within a multidisciplinary framework, are the foundations of enhanced recovery programmes.
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Barclay et al. (2008) conducted a review in Colorectal surgery. Enhanced recovery programmes was evaluated. Enhanced recovery programmes in colorectal surgery are founded on minimizing the metabolic response to surgery and questioning routine use of mechanical bowel preparation, drains, and fasting.
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