Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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Multicenter Study
The influence of an enhanced recovery programme on clinical outcomes, costs and quality of life after surgery for colorectal cancer.
Optimizing peri-operative care using an enhanced recovery programme improves short-term outcomes following colonic resection. This study compared a prospective group of patients undergoing resection of colorectal cancer within an enhanced recovery programme, with a prospectively studied historic cohort receiving conventional care. ⋯ Patients undergoing colorectal resection within an ERP stay in hospital half as long as those receiving conventional care, with no increased morbidity, deterioration in quality of life or increased cost.
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Laparoscopic colonic resection may facilitate early postoperative recovery due to reduced surgical stress, pain and ileus. However, large randomised studies have only shown marginal improvements in outcome compared with open surgery, reporting a median hospital stay of about 5-7 days. ⋯ Recent single centre, randomised studies where laparoscopic and open colonic resection are combined with multimodal rehabilitation have not resolved the debate regarding which is the optimal operative technique. Therefore, new strategies are required to integrate laparoscopy with multimodal rehabilitation in order to establish its advantages, cost effectiveness and indications in specific groups of patients or colorectal procedures, thus justifying widespread application of the laparoscopic technique.