DURHAM, N.C. Changes in managing patients before, during and after colorectal surgery cut hospital stays by two days and reduced readmission rates, according to researchers who led a study of the approach at Duke University Hospital.
The practice, called enhanced recovery, is easier on patients before surgery, doing away with the fasting period and bowel evacuation that are typically prescribed. After surgery, patients are encouraged to eat and move about as soon as possible, leading to faster recoveries.
Among findings published in the May 2014 issue of the journal Anesthesia & Analgesia, the researchers reported that the enhanced recovery approach used for colorectal surgery cut hospital admissions from an average seven days to five, and reduced the rate of readmissions by half.
"Enhanced recovery is about change management," said senior author Tong J. Gan, M.D., MHS, professor of anesthesiology at Duke. "It's getting the team together, including nurses, anesthesiologists, surgeons and patients, with everyone understanding the expectations of how to do things differently and improve patient care."
Gan and colleagues collected data from 241 consecutive patients at Duke University Hospital undergoing open or laparoscopic colorectal surgery during two time periods: before the enhanced recovery approach was implemented, and after. Ninety-nine patients were studied in the traditional approach, and 142 using enhanced recovery.
With traditional perioperative care defined as the care provided through a patient's hospitalization for surgery few procedures are standardized, but patients are typically told to fast the night before and undergo laxative treatments, and then are not given food or drink after surgery until bowel sounds are restored, sometimes several days later. Additionally, traditional perioperative care includes a variety of different anesthesia regimens, fluid management and pain control, depending
|Contact: Sarah Avery|
Duke University Medical Center