Successful enhanced recovery program after colorectal surgery in a county institution

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Patient Recovery Protocols

Background:

• Enhanced recovery programs (ERPs) are increasingly adopted for colorectal surgery to reduce hospital length of stay.
• Successful ERP implementation requires strict adherence to standardized protocols, patient education, and high compliance.
• Assessing the feasibility of ERPs in diverse healthcare settings, like large county hospitals, is crucial.

Purpose of the Study:

• To evaluate the feasibility and effectiveness of an enhanced recovery program in a large county hospital setting for patients undergoing colorectal resection.
• To compare outcomes between patients managed with a conventional approach versus an enhanced recovery protocol.

Main Methods:

• Retrospective review of 54 consecutive patients undergoing segmental colorectal resection (laparoscopic or open, without ostomy).
• Patients were divided into two groups: 27 treated conventionally and 27 treated with an enhanced recovery protocol.
• The enhanced recovery protocol emphasized early feeding, ambulation, and reduced intravenous fluid and narcotic administration.

Main Results:

• Patients in the enhanced recovery program received significantly less intravenous fluids during surgery (P = 0.001) and over the following 3 days (P = 0.0017).
• The enhanced recovery group experienced a significant reduction in hospital length of stay, averaging 4 days compared to 6 days in the conventional group (P = 0.003).
• No significant differences were observed in complication rates or readmission rates between the two groups.

Conclusions:

• Strict adherence to a standard enhanced recovery program is effective in reducing hospital stay for patients undergoing colorectal resection.
• Enhanced recovery programs can be successfully implemented in county hospital settings without increasing patient complications or readmissions.
• These findings support the broader adoption of enhanced recovery protocols in colorectal surgery to improve resource utilization and patient outcomes.