Clin Colon Rectal Surg 2013; 26(03): 139-145
DOI: 10.1055/s-0033-1351128
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Perioperative Protocols in Colorectal Surgery

Mia DeBarros
1   Department of Surgery, Madigan Healthcare System, Tacoma, Washington
,
Scott R. Steele
1   Department of Surgery, Madigan Healthcare System, Tacoma, Washington
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Publikationsdatum:
19. August 2013 (online)

Abstract

The reduction in health-care expenditures and more efficient use of medical resources are now overriding health policy priorities with the two-pronged goal of improving patient outcomes while decreasing overall cost. Current reports show colorectal surgery accounting for 25% of all operative complications and an average length of stay of 8 to 12 days for a standard elective colon resection. To combat this, Kehlet and colleagues introduced a concept of enhanced recovery after surgery (ERAS) or fast-track pathways, with the goal of using current evidence and multimodal therapies to decrease surgical stress, enhance postoperative recovery, and reduce length of stay. The benefits, safety, and cost-effectiveness of fast-track protocols are validated in multiple randomized controlled trials. In this review, the authors focus on the evidence regarding fast-track pathways, use of minimally invasive surgery and its role in fast-track pathways, newer perioperative interventions, and future directions.

 
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