Enhanced Recovery Program in Laparoscopic Colorectal Surgery: An Observational Controlled Trial

Area of Science:

• Colorectal Surgery
• Perioperative Care
• Enhanced Recovery Programs (ERPs)

Background:

• Limited evidence for Enhanced Recovery Programs (ERPs) in colorectal surgery comes from non-randomized studies.
• This study compares coeval groups within the same hospital to evaluate ERP effectiveness.

Purpose of the Study:

• To investigate the impact of a standardized Enhanced Recovery Program (ERP) on functional recovery after elective laparoscopic colorectal resection.
• To compare outcomes between patients undergoing ERP and those receiving traditional perioperative care.

Main Methods:

• Prospective cohort study of 200 patients undergoing elective laparoscopic colorectal resection.
• Comparison between a standardized ERP group (n=100) and a traditional perioperative care group (n=100).
• Exclusion criteria included age >80, ASA IV, metastatic disease, and inflammatory bowel disease.

Main Results:

• Hospital length of stay (LoS) was significantly reduced in the ERP group (4 days vs. 7 days).
• 30-day postoperative complications were significantly lower in the ERP group (P < .001).
• No increase in 30-day readmission or mortality was observed with ERP implementation.

Conclusions:

• Implementing a colorectal ERP is feasible, safe, and effective for improving functional recovery.
• High protocol adherence (81% in this study) is essential for achieving ERP benefits.
• Traditional perioperative care is associated with increased postoperative complications and prolonged LoS.