Enhanced recovery after surgery versus conventional perioperative care in rectal surgery.

Abstract

Enhanced recovery after surgery programs have been developed to improve recovery, shorten hospital stays, and reduce morbidity. The aim of the current study was to examine the effects of the enhanced recovery program on the outcome of rectal surgery. A cohort of patients who underwent open rectal surgery after an enhanced recovery program was compared with a historic case-matched control group receiving conventional perioperative care. Patients were matched for type of surgery, disease, comorbidity, and demographic characteristics. Data regarding fast-track targets, length of hospital stay, mortality, complications, relaparotomies, and readmissions were collected. Forty-one patients in the enhanced recovery group were compared with 82 case-matched patients receiving conventional care. The length of hospital stay (median: 8 days vs 12 days, P < .005) was reduced in the enhanced recovery after surgery group. There were no significant differences in epidural use, mortality, morbidity, and readmission rates between groups. This study performed an intention-to-treat analysis for the multimodal enhanced recovery program in rectal surgery. Specific elements of the program were not analyzed separately. The study used nonrandomly assigned historic controls for comparison. Enhanced recovery after surgery programs help to reduce the length of hospital stay after rectal surgery.