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[Reducing the hospital stay after colorectal resection]
E Pélissier1, O Monek, F Cuche
1CAPIO Clinique Saint-Vincent, 40, chemin des Tilleroyes, 25000 Besançon, France. pelissier.edouard@wanadoo.fr
Annales De Chirurgie
|July 27, 2005
Summary
This study demonstrates that a multimodal approach including epidural analgesia, restricted IV fluids, early feeding, and mobilization can significantly reduce postoperative hospital stays after colorectal resection to a median of 6 days. This strategy benefits patient recovery and reduces healthcare costs.
Area of Science:
- Surgical Oncology
- Gastroenterology
- Enhanced Recovery After Surgery (ERAS) protocols
Background:
- The average postoperative hospital stay following colorectal resection in France is approximately 15 days.
- Published studies indicate shorter stays ranging from 2 to 5 days are achievable.
Purpose of the Study:
- To investigate the feasibility of reducing postoperative hospital stay after colorectal resection to less than 7 days.
Main Methods:
- A study involving 61 patients undergoing colorectal resection via laparotomy.
- Implementation of a protocol including epidural analgesia or wound infusion with ropivacaine, restricted intravenous fluids, early oral feeding, and active mobilization.
Main Results:
- The median discharge time was 6 days (mean 7.3 days).
- 59% of patients were discharged between postoperative days 3 and 6.
- Postoperative complications occurred in 16% of patients, with 5% readmissions and no deaths.
Conclusions:
- A median hospital stay shorter than the current standard can be achieved using simple, cost-effective methods.
- This approach accelerates patient recovery and contributes to significant cost reduction in healthcare.