BACKGROUND: The aim of this study was to determine whether the early postoperative feeding protocol introduced in Western countries is feasible in Japanese patients who undergo oncological colorectal surgery, and to verify the necessity for scheduled postoperative blood samplings and X-rays, and to determine whether, as a result, these measures can lead to a reduction of medical costs and length of hospitalization. METHODS: Group I consisted of 17 patients who received the early postoperative feeding protocol. Group II consisted of 22 patients who received the traditional Japanese feeding protocol. In group I, postoperative clinical tests were performed only once, and in group II, examinations were performed routinely four times according to the traditional protocol. RESULTS: Most of the patients in group I (94.1%) tolerated the early feeding schedule. The length of postoperative hospitalization was significantly shorter in group I (11 +/- 2.96 days vs 18 +/- 4.96 days; P << 0.001). There was no significant difference in morbidity between the two groups. The number of times postoperative clinical tests were performed was significantly lower in group I. Significant reduction of postoperative medical costs was also shown in group I ($2028 US dollars +/- 53 vs $3177 US dollars+/- 1230; P << 0.001). CONCLUSIONS: This study revealed the safety and feasibility of early postoperative feeding and a single-examination protocol following elective oncological colorectal resection in Japanese patients, which led to a reduction in the length of postoperative hospitalization and in health-care costs. We emphasize the importance of meticulous postoperative monitoring of patients rather than the performance of scheduled postoperative examinations that have limited clinical significance.
BACKGROUND: The aim of this study was to determine whether the early postoperative feeding protocol introduced in Western countries is feasible in Japanese patients who undergo oncological colorectal surgery, and to verify the necessity for scheduled postoperative blood samplings and X-rays, and to determine whether, as a result, these measures can lead to a reduction of medical costs and length of hospitalization. METHODS: Group I consisted of 17 patients who received the early postoperative feeding protocol. Group II consisted of 22 patients who received the traditional Japanese feeding protocol. In group I, postoperative clinical tests were performed only once, and in group II, examinations were performed routinely four times according to the traditional protocol. RESULTS: Most of the patients in group I (94.1%) tolerated the early feeding schedule. The length of postoperative hospitalization was significantly shorter in group I (11 +/- 2.96 days vs 18 +/- 4.96 days; P << 0.001). There was no significant difference in morbidity between the two groups. The number of times postoperative clinical tests were performed was significantly lower in group I. Significant reduction of postoperative medical costs was also shown in group I ($2028 US dollars +/- 53 vs $3177 US dollars+/- 1230; P << 0.001). CONCLUSIONS: This study revealed the safety and feasibility of early postoperative feeding and a single-examination protocol following elective oncological colorectal resection in Japanese patients, which led to a reduction in the length of postoperative hospitalization and in health-care costs. We emphasize the importance of meticulous postoperative monitoring of patients rather than the performance of scheduled postoperative examinations that have limited clinical significance.
Authors: Joseph C Carmichael; Deborah S Keller; Gabriele Baldini; Liliana Bordeianou; Eric Weiss; Lawrence Lee; Marylise Boutros; James McClane; Scott R Steele; Liane S Feldman Journal: Surg Endosc Date: 2017-08-03 Impact factor: 4.584