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Am J Surg. 2010 Mar;199(3):299-304; discussion 304. doi: 10.1016/j.amjsurg.2009.08.027.

Association of surgical care practices with length of stay and use of clinical protocols after elective bowel resection: results of a national survey.

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1
Division of Colorectal Surgery, University Hospitals Case Medical Center, 11100 Euclid Ave., Cleveland, OH 44106-5047, USA. Conor.Delaney@uhhospitals.org

Abstract

BACKGROUND:

Although management techniques have been proposed to accelerate gastrointestinal recovery after elective bowel resection (BR), most data are derived from single-institution experience. This study assessed the current state of perioperative care for elective BRs and the effect of pathway components on length of stay.

METHODS:

A web-based survey was conducted among surgeons regarding their last elective BR.

RESULTS:

Among 207 general and 200 colorectal surgeons, 30% practice in hospitals with a perioperative surgical care pathway intended to accelerate gastrointestinal recovery. Pathway components included early ambulation, early diet progression, early nasogastric tube removal/avoidance, and opioid-sparing pain control. Care practices associated with decreased length of stay included laparoscopic technique, early mobilization, early liquids, and antiemetic use to prevent symptoms associated with prolonged postoperative ileus.

CONCLUSIONS:

Few hospitals have pathways but most surgeons likely would implement nationally endorsed guidelines. These data, along with other studies, may lead to well-accepted BR care pathways.

PMID:
20226899
DOI:
10.1016/j.amjsurg.2009.08.027
[Indexed for MEDLINE]

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