Enhanced Recovery Program Safely Improves The Outcome Of Elective Left Colorectal Surgery
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Objectives : This study aimed at evaluating the outcome of enhanced recovery (ER) program for patients assigned for elective colorectal surgery in comparison to the standard care (SC) program Patients & Methods: The study included 60 patients 35 females (58.3%) and 25 males (41.7%) with mean age of675.8 years. There were 24 ASA-1 patients, 26 ASA-Il patients and 10 ASA-IH patients. Patients were randomly divided into 2 equal groups: Group ER included patients assigned to receive enhanced recovery perioperative care program and Group SC included patients assigned to receive the standard perioperative care program. Operative blood loss, need for blood transfusion and amount of blood units used and duration of surgery were recorded. Duration of hospital stay and immediate postoperative (PO) measures including PO morbidity, requirement for post anesthesia care unit (PACU) or hospital re-admission were determined. Results : There was a non-significant difference between studied patients as regards operative time, infraoperative blood loss or the frequency of blood transfusion. Mean total pain score determined at PO 48-hrs was significantly lower in ER group compared to SC group. Group ER patients resumed PO oral intake after 2.6 0.5 hr and received semi-solid diet on evening, while in group SC, oral feeding was resumed after 67.2 23.7 hr with significant difference in favor of group ER. PO ambulation was started 2-hrs and one day after surgery in Groups ER and SC, respectively with significantly longer time out off bed in Group ER. Moreover, the mean time out off bed throughout the duration of hospital stay was significantly longer in Group ER compared to Group SC. The mean duration to fulfill discharge criteria was significantly shorter in Group ER compared to Group SC. Ten patients, 4 in group ER and 6 in group SC required re-admission with significantly shorter mean total hospital stay was in group ER. There was a nonsignificant difference between both groups as regards the frequency ofPO complications. Conclusion: Enhanced recovery program is appropriate for management of high-risk colorectal cancer patients with significantly shorter duration of hospital stay and lower re-admission rate and PO complications witli its consequent reduction of costs and preservation of hospital resources.