Enhanced recovery pathway for urgent colectomy.

Details

Serval ID
serval:BIB_D239E2AAD440
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Enhanced recovery pathway for urgent colectomy.
Journal
World Journal of Surgery
Author(s)
Roulin D., Blanc C., Muradbegovic M., Hahnloser D., Demartines N., Hübner M.
ISSN
1432-2323 (Electronic)
ISSN-L
0364-2313
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
38
Number
8
Pages
2153-2159
Language
english
Notes
Publication types: Journal Article Publication Status: ppublish
Abstract
BACKGROUND: Enhanced recovery protocols have been proven to decrease complications and hospital stay following elective colorectal surgery. However, these principles have not yet been reported for urgent surgery procedures. We aimed to assess our initial experience with urgent colectomies performed within an established enhanced recovery pathway.
METHODS: In a prospective cohort study, all patients undergoing colonic resection between April 2012 and March 2013 were treated according to a standardized enhanced recovery protocol. Urgent surgeries were compared with the elective procedures with regards to baseline characteristics, compliance with enhanced recovery items, and clinical outcome.
RESULTS: Patients (N = 28) requiring urgent colonic resection were included and compared with patients undergoing elective colectomy (N = 63). Overall compliance with the protocol was 57% for the urgent compared with 77% for the elective procedures (p = 0.006). The pre-operative compliance was 64 versus 96% (p < 0.001), the intra-operative compliance was 77 versus 86% (p = 0.145), and the post-operative compliance was 49 versus 67% (p = 0.015), for the urgent and elective resections, respectively. Overall, 18 urgent patients (64%) and 32 elective patients (51%) developed postoperative complications (p = 0.261). Median postoperative length of stay was 8 days in the urgent setting compared with 5 days in the elective setting (p = 0.006).
CONCLUSIONS: Many of the intra-operative and post-operative enhanced recovery items can also be applied to urgent colectomy, entailing outcomes that approach the results achieved in the elective setting.
Pubmed
Web of science
Create date
08/08/2014 17:33
Last modification date
13/05/2020 5:22
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