Key result
The standardized postoperative enhanced recovery program significantly reduced the postoperative hospital stay from 10.43 to 6.76 days compared to traditional care, without increasing complications.
Why the study?
Does a standardized postoperative enhanced recovery program improve recovery and clinical outcomes in patients undergoing laparoscopic colorectal resection for colorectal cancer?
Cohort (n=124)
No
Does a standardized postoperative enhanced recovery program improve recovery and clinical outcomes in patients undergoing laparoscopic colorectal resection for colorectal cancer?
Absolute Event Rate: 6.76% vs 10.43%
p-value: p=0.0001
A standardized postoperative enhanced recovery program after laparoscopic colorectal resection significantly reduces hospital stay and intravenous fluid/antibiotic use without increasing complications or readmissions.
May shorten stays in colorectal surgery; hypothesis-generating pending randomized confirmation.
Purpose: A multidisciplinary program for early recovery after colorectal surgery has been developed continuously since 2000.The purpose of this study was to evaluate the effects of the standardized postoperative enhanced recovery program (SPERP) after a colorectal resection.Methods: The patients undergoing laparoscopic colorectal resection for colorectal cancer were cared for by using the SPERP after surgery.The comparison group consisted of patients who had undergone similar surgery before establishment of the SPERP.The two groups were compared with respect to the patients' characteristics, operation methods, operation time, blood loss, amounts of intravenous fluid and intravenous antibiotics, complications, postoperative hospital stay, readmission rate, and reoperation rate.Results: The number of patients being treated with the standardized postoperative recovery program, the standardized group (SG), was 63, and that of the traditional group (TG) was 61.Even though the day of oral feeding (1.02 vs. 2.67 days) was faster in the SG, the day of flatus and defecation was not different between two groups.The postoperative hospital stay in the SG (6.76 days) was significantly shorter than that in the TG (10.43 days).The total amount of intravenous fluid after surgery in the SG was 8,574.75mL, compared with 19,568.22mL in the TG.The duration of intravenous antibiotics was 2.69 days in the SG and 7.38 days in the TG (P=0.0001).The rates of complication (27.0% in SG vs. 39.3% in TG), reoperation (3.17% vs. 9.84%), and readmission (7.94% vs. 6.56%) did not increase after implementation of this program.Conclusion: The standardized postoperative recovery program reduced the amounts of postoperative intravenous fluid and antibiotics and the postoperative hospital stay without increasing either complications or the readmission rate.A prospective multi-center study of this program is needed.
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Joh et al. (2010) conducted a cohort in Colorectal cancer (n=124). Standardized postoperative enhanced recovery program (SPERP) vs. Traditional postoperative care was evaluated on Postoperative hospital stay (days) (p=0.0001). The standardized postoperative enhanced recovery program significantly reduced the postoperative hospital stay from 10.43 to 6.76 days compared to traditional care, without increasing complications.
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