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J Chir (Paris). 2007 May-Jun;144(3):191-6.

[Accelerated postoperative recovery after colorectal surgery].

[Article in French]

Author information

  • 1Département d'Anesthésie-Réanimation, Hôpital A. Paré, Boulogne Cedex. pascal.alfonsi@apr.aphp.fr

Abstract

Accelerated recovery programs are clinical pathways which outline the stages, and streamline the means, and techniques aiming toward the desired end a rapid return of the patient to his pre-operative physical and psychological status. Recovery from colo-rectal surgery may be slowed by the patient's general health, surgical stress, post-surgical pain, and post-operative ileus. Both surgeons and anesthesiologists participate throughout the peri-operative period in a clinical pathway aimed at minimizing these delaying factors. Key elements of this pathway include avoidance of pre-operative colonic cleansing, early enteral feeding, and effective post-operative pain management permitting early ambulation (usually via thoracic epidural anesthesia). Pre-operative information and motivation of the patient is also a key to the success of this accelerated recovery program. Studies of such programs have shown decreased duration of post-operative ileus and hospital stay without an increase in complications or re-admissions. The elements of the clinical pathway must be regularly re-evaluated and updated according to local experience and published data.

PMID:
17925710
[PubMed - indexed for MEDLINE]
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