The Effect of an Enhanced Recovery Program on Elective Right Hemicolectomies for Crohn's Disease vs. Colon Cancer: A Retrospective Cohort Analysis.
Aged
Colonic Neoplasms
/ surgery
Crohn Disease
/ surgery
Elective Surgical Procedures
/ adverse effects
Enhanced Recovery After Surgery
Female
Heart Failure
/ epidemiology
Humans
Ileum
/ surgery
Ileus
/ epidemiology
Length of Stay
Male
Operative Time
Patient Readmission
Postoperative Complications
/ epidemiology
Pulmonary Disease, Chronic Obstructive
/ epidemiology
Retrospective Studies
Treatment Outcome
colorectal
enhanced recovery after surgery
general surgery
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
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