Does an enhanced recovery programme add value to laparoscopic colorectal resections?

Area of Science:

• Colorectal Surgery
• Surgical Outcomes
• Minimally Invasive Surgery

Background:

• Enhanced Recovery Programs (ERP) are increasingly vital for colorectal resection patients.
• While ERP benefits in open surgery are established, their impact on laparoscopic procedures remains under investigation.
• This study evaluates ERP's effectiveness in a high-volume laparoscopic colorectal surgery setting.

Purpose of the Study:

• To assess the impact of Enhanced Recovery Programs (ERP) on laparoscopic colorectal resections.
• To determine if ERP reduces post-operative length of stay and morbidity in this patient group.
• To evaluate ERP's value in a unit with a high prevalence of laparoscopic colorectal surgery.

Main Methods:

• Analysis of a prospectively maintained database of colorectal resections from January 2008 to December 2012.
• ERP program introduced in August 2010, allowing pre- and post-ERP comparison.
• Primary outcome: post-operative length of stay. Secondary outcomes: post-operative morbidity and mortality.

Main Results:

• 506 patients underwent major colorectal resections; 282 received care post-ERP introduction.
• Median length of stay decreased from 6 days (pre-ERP) to 5 days (post-ERP).
• Morbidity and mortality were lower in the ERP group, though not statistically significant.

Conclusions:

• Enhanced Recovery Programs (ERP) provide significant benefits for laparoscopic colorectal resections.
• ERP implementation is associated with reduced length of stay and a trend towards lower morbidity.
• The findings support the integration of ERP into laparoscopic colorectal surgery protocols.