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. |
