[Accelerated postoperative recovery after colorectal surgery]

Area of Science:

• Surgical recovery protocols
• Peri-operative care optimization
• Clinical pathway development

Context:

• Colorectal surgery recovery can be prolonged by factors like general health, surgical stress, pain, and post-operative ileus.
• Multidisciplinary teams (surgeons, anesthesiologists) implement peri-operative pathways to mitigate these recovery delays.
• Patient pre-operative education and motivation are crucial for successful accelerated recovery.

Purpose:

• To outline and streamline clinical pathways for accelerated patient recovery post-colorectal surgery.
• To minimize factors that slow recovery, such as post-operative ileus and prolonged hospital stays.
• To facilitate a rapid return to pre-operative physical and psychological status.

Summary:

• Accelerated recovery programs (ARPs) utilize specific peri-operative strategies, including avoiding pre-operative bowel preparation, early enteral nutrition, and effective pain management with thoracic epidural anesthesia for early ambulation.
• Key elements involve a multidisciplinary approach to minimize surgical stress and post-operative ileus.
• Pre-operative patient engagement is vital for the success of these programs.

Impact:

• Studies demonstrate that ARPs reduce the duration of post-operative ileus and hospital length of stay.
• These programs achieve faster recovery without a significant increase in surgical complications or patient re-admissions.
• Continuous re-evaluation and updating of ARP elements based on clinical data and research are essential for sustained effectiveness.