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World Journal of Surgery

, Volume 38, Issue 8, pp 2153–2159 | Cite as

Enhanced Recovery Pathway for Urgent Colectomy

  • Didier Roulin
  • Catherine Blanc
  • Mirza Muradbegovic
  • Dieter Hahnloser
  • Nicolas Demartines
  • Martin Hübner
Article

Abstract

Background

Enhanced recovery protocols have been proven to decrease complications and hospital stay following elective colorectal surgery. However, these principles have not yet been reported for urgent surgery procedures. We aimed to assess our initial experience with urgent colectomies performed within an established enhanced recovery pathway.

Methods

In a prospective cohort study, all patients undergoing colonic resection between April 2012 and March 2013 were treated according to a standardized enhanced recovery protocol. Urgent surgeries were compared with the elective procedures with regards to baseline characteristics, compliance with enhanced recovery items, and clinical outcome.

Results

Patients (N = 28) requiring urgent colonic resection were included and compared with patients undergoing elective colectomy (N = 63). Overall compliance with the protocol was 57 % for the urgent compared with 77 % for the elective procedures (p = 0.006). The pre-operative compliance was 64 versus 96 % (p < 0.001), the intra-operative compliance was 77 versus 86 % (p = 0.145), and the post-operative compliance was 49 versus 67 % (p = 0.015), for the urgent and elective resections, respectively. Overall, 18 urgent patients (64 %) and 32 elective patients (51 %) developed postoperative complications (p = 0.261). Median postoperative length of stay was 8 days in the urgent setting compared with 5 days in the elective setting (p = 0.006).

Conclusions

Many of the intra-operative and post-operative enhanced recovery items can also be applied to urgent colectomy, entailing outcomes that approach the results achieved in the elective setting.

Keywords

Elective Patient Elective Colorectal Surgery Elective Setting Elective Group Urgent Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

The authors would like to acknowledge the support provided by all members of the enhanced recovery team in Lausanne, especially V. Addor, our enhanced recovery-dedicated Clinical Nurse.

Disclosure

Grant support and conflict of interest: none.

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Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Didier Roulin
    • 1
  • Catherine Blanc
    • 2
  • Mirza Muradbegovic
    • 1
  • Dieter Hahnloser
    • 1
  • Nicolas Demartines
    • 1
  • Martin Hübner
    • 1
  1. 1.Department of Visceral SurgeryUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland
  2. 2.Department of AnesthesiologyUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland

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