BACKGROUND: Enhanced recovery programmes (ERPs) have demonstrated reduced morbidity and length of hospital stay in patients undergoing open elective colorectal resections. The application of laparoscopic techniques to colorectal surgery is associated with shorter length of stay and morbidity compared to open resections. In the setting of laparoscopic surgery, it is unclear whether there is an additive effect on length of stay and morbidity by combining these. The current study addresses the benefit of an ERP (RAPID protocol) in a cohort of matched patients undergoing laparoscopic sigmoid colon resection MATERIALS AND METHODS: Consecutive patients over a 40-month period who underwent laparoscopic sigmoid colon resection were assigned either to the RAPID protocol (group 1) or traditional post operative care (group 2) in a non-randomised manner. Analysis was on an "intention to treat" basis. Primary and secondary endpoints were identified; primary endpoints included length of hospital stay and readmission rate. Secondary endpoints included morbidity and mortality rate. RESULTS: Seventy-three consecutive patients were included. Group 1 included 37 patients. Group 2 included 36 patients. Median length of hospital stay in groups 1 and 2 was 5 and 8 days, respectively (p = 0.01). Readmission rate in groups 1 and 2 was 8.1% and 8.3%, respectively (p = 0.98). Morbidity rate in groups 1 and 2 was 30% and 22%, respectively (p = 0.61); there was one mortality in each group. CONCLUSION: The application of the ERP (RAPID) to patients undergoing laparoscopic sigmoid colon resection results in a significant improvement in length of hospital stay, with comparable morbidity and readmission rates.
BACKGROUND: Enhanced recovery programmes (ERPs) have demonstrated reduced morbidity and length of hospital stay in patients undergoing open elective colorectal resections. The application of laparoscopic techniques to colorectal surgery is associated with shorter length of stay and morbidity compared to open resections. In the setting of laparoscopic surgery, it is unclear whether there is an additive effect on length of stay and morbidity by combining these. The current study addresses the benefit of an ERP (RAPID protocol) in a cohort of matched patients undergoing laparoscopic sigmoid colon resection MATERIALS AND METHODS: Consecutive patients over a 40-month period who underwent laparoscopic sigmoid colon resection were assigned either to the RAPID protocol (group 1) or traditional post operative care (group 2) in a non-randomised manner. Analysis was on an "intention to treat" basis. Primary and secondary endpoints were identified; primary endpoints included length of hospital stay and readmission rate. Secondary endpoints included morbidity and mortality rate. RESULTS: Seventy-three consecutive patients were included. Group 1 included 37 patients. Group 2 included 36 patients. Median length of hospital stay in groups 1 and 2 was 5 and 8 days, respectively (p = 0.01). Readmission rate in groups 1 and 2 was 8.1% and 8.3%, respectively (p = 0.98). Morbidity rate in groups 1 and 2 was 30% and 22%, respectively (p = 0.61); there was one mortality in each group. CONCLUSION: The application of the ERP (RAPID) to patients undergoing laparoscopic sigmoid colon resection results in a significant improvement in length of hospital stay, with comparable morbidity and readmission rates.
Authors: J Maessen; C H C Dejong; J Hausel; J Nygren; K Lassen; J Andersen; A G H Kessels; A Revhaug; H Kehlet; O Ljungqvist; K C H Fearon; M F von Meyenfeldt Journal: Br J Surg Date: 2007-02 Impact factor: 6.939
Authors: Kirk Ludwig; Warren E Enker; Conor P Delaney; Bruce G Wolff; Wei Du; John G Fort; Maryann Cherubini; James Cucinotta; Lee Techner Journal: Arch Surg Date: 2008-11
Authors: S Power; D O Kavanagh; G McConnell; K Cronin; C Corish; M Leonard; A Crean; S Feehan; E Eguare; P Neary; J Connolly Journal: Ir J Med Sci Date: 2011-09-30 Impact factor: 1.568
Authors: Diarmaid C Moran; Dara O Kavanagh; Emmeline Nugent; Niall Swan; Emmanuel Eguare; Diarmuid O'Riordain; Frank B V Keane; Paul C Neary Journal: Int J Colorectal Dis Date: 2011-05-06 Impact factor: 2.571
Authors: Vijaya Gottumukkala; Thomas A Aloia; Ryan W Day; Sharon Fielder; John Calhoun; Henrik Kehlet Journal: Br J Surg Date: 2015-09-14 Impact factor: 6.939