The Effect of an Enhanced Recovery Program on Elective Right Hemicolectomies for Crohn's Disease vs. Colon Cancer: A Retrospective Cohort Analysis.


Journal

The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522

Informations de publication

Date de publication:
Jan 2022
Historique:
pubmed: 29 12 2020
medline: 24 12 2021
entrez: 28 12 2020
Statut: ppublish

Résumé

Enhanced recovery after surgery (ERAS) protocols are widely employed in colorectal surgery, successful in reducing postoperative morbidities and hospital length of stay (LOS). However, ERAS effects on the inflammatory bowel disease population remain unclear. This study examines the postoperative course of both Crohn's disease (CD) and colon cancer (CC) patients after elective right hemicolectomies and compares the effectiveness of ERAS protocol. A retrospective analysis was performed on patients with CD and CC undergoing elective right hemicolectomies and ileocecectomies from January 2014 through June 2016 (pre-ERAS) and January 2017 through April 2019 (post-ERAS) from a single tertiary care center. Patient demographics and perioperative variables were examined, including prolonged postoperative ileus (PPOI), hospital LOS, and 30-day readmission. 98 CC patients and 91 CD patients met the inclusion criteria. The pre-ERAS CC and post-ERAS CC cohorts were significantly different: post-ERAS had fewer patients with congestive heart failure and chronic obstructive pulmonary disease and had higher albumin levels. The pre-ERAS CC cohort had significantly longer operative durations and higher rates of concomitant procedures than the post-ERAS CC cohort. Both patients with CC and CD had a reduction in LOS with implementation of ERAS, decreasing by 2.24 days ( The ERAS protocol significantly reduced LOS for both groups, without increasing 30-day readmission rates or other morbidities.

Sections du résumé

BACKGROUND BACKGROUND
Enhanced recovery after surgery (ERAS) protocols are widely employed in colorectal surgery, successful in reducing postoperative morbidities and hospital length of stay (LOS). However, ERAS effects on the inflammatory bowel disease population remain unclear. This study examines the postoperative course of both Crohn's disease (CD) and colon cancer (CC) patients after elective right hemicolectomies and compares the effectiveness of ERAS protocol.
METHODS METHODS
A retrospective analysis was performed on patients with CD and CC undergoing elective right hemicolectomies and ileocecectomies from January 2014 through June 2016 (pre-ERAS) and January 2017 through April 2019 (post-ERAS) from a single tertiary care center. Patient demographics and perioperative variables were examined, including prolonged postoperative ileus (PPOI), hospital LOS, and 30-day readmission.
RESULTS RESULTS
98 CC patients and 91 CD patients met the inclusion criteria. The pre-ERAS CC and post-ERAS CC cohorts were significantly different: post-ERAS had fewer patients with congestive heart failure and chronic obstructive pulmonary disease and had higher albumin levels. The pre-ERAS CC cohort had significantly longer operative durations and higher rates of concomitant procedures than the post-ERAS CC cohort. Both patients with CC and CD had a reduction in LOS with implementation of ERAS, decreasing by 2.24 days (
DISCUSSION CONCLUSIONS
The ERAS protocol significantly reduced LOS for both groups, without increasing 30-day readmission rates or other morbidities.

Identifiants

pubmed: 33356439
doi: 10.1177/0003134820982573
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

120-125

Auteurs

David R Croasdale (DR)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

Emily M Su (EM)

Albany Medical College, Albany, NY, USA.

Olatoye E Olutola (OE)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

Caroline P Polito (CP)

12300Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA.

Ashar Ata (A)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

Megan Keenan (M)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

Brian T Valerian (BT)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

A David Chismark (A)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

Jonathan J Canete (JJ)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

Edward C Lee (EC)

Department of Surgery, 138207Albany Medical Center, Albany, NY, USA.

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Classifications MeSH