World Journal of Surgery

, Volume 40, Issue 10, pp 2519–2527 | Cite as

Enhanced Recovery Pathway for Right and Left Colectomy: Comparison of Functional Recovery

  • Anne Kummer
  • Juliette Slieker
  • Fabian Grass
  • Dieter Hahnloser
  • Nicolas DemartinesEmail author
  • Martin Hübner
Original Scientific Report



Enhanced recovery (ERAS) guidelines do not differentiate between left- and right-sided colectomies, but differences in recovery have been reported for the two procedure types. We aimed to compare compliance with the ERAS protocol and outcomes after right versus left colectomy.


Between June 2011 and September 2014, all patients undergoing elective colonic resection were treated according to a standardized ERAS protocol and entered a prospective database. This retrospective analysis compared right and left colectomy regarding application of the ERAS pathway, bowel recovery, complications, and hospital stay.


Eighty-five patients with right colectomy matched well with 138 left-sided resections for baseline demographics. Overall compliance with the ERAS protocol was 76 % for right versus 77 % for left colectomy patients (p = 0.492). First flatus occurred at postoperative day 2 in both groups (p = 0.057); first stool was observed after a median of 3 (right) and 2 days (left), respectively (p = 0.189). Twenty patients (24 %) needed postoperative nasogastric tube after right colectomy compared to 11 patients (8 %) after left colectomy (p = 0.002). Overall complication rates were 49 and 37 % for right and left colectomy, respectively (p = 0.071). Median postoperative length of stay was 6 days (IQR 4–9) after right and 5 days (IQR 4–7.5) after left colectomy (p = 0.020).


Overall compliance with the protocol was equally high in both groups showing that ERAS protocol was applicable for right and left colectomy. Functional recovery however, tended to be slower after right colectomy, and postoperative ileus rate was significantly higher. More cautious early feeding after right colectomy should be considered.


Postoperative Ileus Alvimopan Ileus Rate Left Colectomy Colectomy Group 
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.



Enhanced recovery after surgery


Postoperative day


Compliance with ethical standards


No external funding was required for this study.

Supplementary material

268_2016_3563_MOESM1_ESM.pdf (68 kb)
Supplementary material 1 (PDF 68 kb)


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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  • Anne Kummer
    • 1
  • Juliette Slieker
    • 1
  • Fabian Grass
    • 1
  • Dieter Hahnloser
    • 1
  • Nicolas Demartines
    • 1
    Email author
  • Martin Hübner
    • 1
  1. 1.Department of Visceral SurgeryUniversity Hospital of Lausanne (CHUV)LausanneSwitzerland

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