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Comparison of outcome after right colectomy with an enhanced recovery programme in patients with inflammatory bowel disease and patients operated on for other conditions: a monocentric retrospective study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

A Correction to this article was published on 28 January 2021

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Abstract

Purpose

Enhanced recovery programmes (ERPs) after surgery reduce postoperative complications and hospital stay. Patients with inflammatory bowel disease (IBD) often present risk factors for postoperative complications. This accounts for reluctance to include them in ERPs. We compared outcome after right colectomy with an ERP in IBD and non-IBD patients.

Methods

In our GRACE colorectal surgery database comprising 508 patients, we analysed patients scheduled for right colectomy (n = 160). Adherence to the protocol, postoperative complications and length of hospital stay of IBD patients (n = 45) were compared with those of non-IBD patients (n = 115). Data (mean ± SD, median [IQR], count (%)) were compared by Student’s t, Mann-Whitney U and chi-square tests when appropriate; p < 0.05 taken as statistically significant.

Results

IBD patients were significantly younger (38.9 ± 13.8 vs. 58.9 ± 18.5 years, p < 0.001) and had lower BMI (23.0 ± 5.0 vs. 25.1 ± 5.0 kg m−2, p < 0.01). Adherence to ERP was similar in the two groups. Resumption of eating on the day of the operation was less well tolerated (73.3% vs. 85.2%, p < 0.05) and postoperative pain (p < 0.001) was greater in IBD patients. The incidence of postoperative complications (13.3% vs. 17.3%) and the length of hospital stay (3 [3–4.5] vs. 3 [2,3,4,5] days) were comparable in IBD and non-IBD patients, respectively.

Conclusion

The management of IBD patients in an ERP is not only feasible but also indicated. These patients benefit as much from ERP as non-IBD patients.

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Funding

This study received financial support from GRACE (Francophone group for enhanced recovery after surgery, Beaumont, France, https://www.grace-asso.fr). The funding source had no involvement in study design, collection, analysis or interpretation of data, in the writing of the report, or in the decision to submit the article for publication

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Authors and Affiliations

  1. Department of Anaesthesiology and Reanimation, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, avenue de l’hôpital Bat B35, B-4000, Liège, Belgium

    Anne Meunier, Pierre-Yves Hardy & Jean Joris

  2. Service of Abdominal Surgery, CHU Liège, University of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium

    Giuseppe Sorce, Carla Coimbra & Emmanuel Decker

  3. Groupe francophone de réhabilitation améliorée après chirurgie (GRACE; Francophone group for enhanced recovery after surgery, www.grace-asso.fr), Beaumont, France

    Jean Joris

Authors
  1. Anne Meunier
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  2. Giuseppe Sorce
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  3. Pierre-Yves Hardy
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  4. Carla Coimbra
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  5. Emmanuel Decker
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Contributions

Anne Meunier: study design, data collection, analysis and interpretation of results, manuscript reviewing; Giuseppe Sorce: study design, data collection, analysis and interpretation of results, manuscript reviewing; Pierre-Yves Hardy: study design, data collection, analysis and interpretation of results, statistical analyses, manuscript reviewing; Carla Coimbra: study design, patient recruitment, analysis and interpretation of results, manuscript reviewing; Emmanuel Decker: study design, patient recruitment, analysis and interpretation of results, manuscript reviewing; Jean Joris: study design, patient recruitment, data collection, statistical analyses, analysis and interpretation of results and writing up of the manuscript. All the authors gave final approval of the version to be published

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Correspondence to Jean Joris.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

The original online version of this article was revised: The URL in the affiliation was presented incorrectly as “www.grace-asso.fr instead of www.grace-aaso.fr.” This should have been “www.grace-asso.fr”.

In the third paragraph under the “Discussion” section, the text IBM in the sentence “Tolerance of early feeding on the day of surgery was, however, lower than in IBD patients as also reported by others [18].” should read as “non-IBM”.

Accepted at the 2020 SFAR (Société Française d’Anesthésie Réanimation) annual meeting, September 24 2020 (cancelled due to COVID crisis).

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Meunier, A., Sorce, G., Hardy, PY. et al. Comparison of outcome after right colectomy with an enhanced recovery programme in patients with inflammatory bowel disease and patients operated on for other conditions: a monocentric retrospective study. Int J Colorectal Dis 36, 757–763 (2021). https://doi.org/10.1007/s00384-020-03830-5

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  • DOI: https://doi.org/10.1007/s00384-020-03830-5

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