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World J Surg. 2013 Oct;37(10):2483-9. doi: 10.1007/s00268-013-2155-x.

Two-day hospital stay after laparoscopic colorectal surgery under an enhanced recovery after surgery (ERAS) pathway.

Author information

1
Section of Colorectal Surgery, Service of General Surgery, Hospital Italiano de Buenos Aires, 450 Gascón st, 1181 Buenos Aires, Argentina. gustavo.rossi@hospitalitaliano.org.ar

Abstract

BACKGROUND:

The present study aims to examine the feasibility and safety of a two-day hospital stay after laparoscopic colorectal resection (LCR) under an enhanced recovery after surgery (ERAS) pathway.

METHODS:

Between 2003 and 2010, 882 consecutive patients undergoing LCR were analyzed. Patients were grouped and analyzed according to whether their hospital stay was 2 days (group A) or longer (group B). Demographic, surgical, and postoperative data were compared. To identify independent predictive factors related to a short hospital stay, a multivariate analysis was also performed.

RESULTS:

Group A represented 10.3 % of this series (91 patients). There were no differences regarding age, gender, BMI, ASA, and previous abdominal surgeries between groups. Group A had a lower incidence of rectal cancer and anterior resections than group B (6.6 vs. 17.7 % [p = 0.006] and 14.3 vs. 23.4 % [p = 0.048]), respectively, and a lower mean operative time (170 min vs. 192 min; p = 0.002). Group A had a lower overall morbidity rate than group B (5.5 vs. 16.9 %; p = 0.004) and a lower incidence of surgery-related complications (5.5 vs. 14.9 %; p = 0.001). The overall conversion rate was 10 % (only one patient in group A required conversion), and the difference in conversion rate between groups was statistically significant (1.2 vs. 10.7 %; p = 0.003). Group A had a lower readmission rate (0 vs. 4.9 %; p = 0.089). Multivariate analysis showed that conversion, postoperative morbidity, and rectal prolapse were independently associated with the length of hospital stay.

CONCLUSIONS:

A two-day hospital stay after LCR is safe and feasible under an ERAS pathway, without compromising the readmission or complication rate.

PMID:
23881088
PMCID:
PMC3755219
DOI:
10.1007/s00268-013-2155-x
[Indexed for MEDLINE]
Free PMC Article

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