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BMC Cancer

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Open Access 01-12-2024 | Colectomy | Research

Accelerated enhanced recovery after colon cancer surgery with discharge within one day after surgery: a systematic review

Authors: Misha A. T. Sier, Anke H. C. Gielen, Thaís T. T. Tweed, Noémi C. van Nie, Tim Lubbers, Jan H. M. B. Stoot

Published in: BMC Cancer | Issue 1/2024

Abstract

Background

Recent studies have demonstrated that accelerated enhanced recovery after colorectal surgery is feasible for specific patient populations. The accelerated enhanced recovery protocols (ERP) tend to vary, and the majority of studies included a small study population. This hampers defining the optimal protocol and establishing the potential benefits. This systematic review aimed to determine the effect of accelerated ERPs with intended discharge within one day after surgery.

Methods

PubMed (MEDLINE), Embase, Cochrane and Web of Science databases were searched using the following search terms: colon cancer, colon surgery, accelerated recovery, fast track recovery, enhanced recovery after surgery. Clinical trials published between January 2005 – February 2023, written in English or Dutch comparing accelerated ERPs to Enhanced Recovery After Surgery (ERAS) care for adult patients undergoing elective laparoscopic or robotic surgery for colon cancer were eligible for inclusion.

Results

Thirteen studies, including one RCT were included. Accelerated ERPs after colorectal surgery was possible as LOS was shorter; 14 h to 3.4 days, and complication rate varied from 0–35.7% and readmission rate was 0–17% in the accelerated ERP groups. Risk of bias was serious or critical in most of the included studies.

Conclusions

Accelerated ERPs may not yet be considered the new standard of care as the current data is heterogenous, and data on important outcome measures is scarce. Nonetheless, the decreased LOS suggests that accelerated recovery is possible for selected patients. In addition, the complication and readmission rates were comparable to ERAS care, suggesting that accelerated recovery could be safe.

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Title: Accelerated enhanced recovery after colon cancer surgery with discharge within one day after surgery: a systematic review
Authors: Misha A. T. Sier
Anke H. C. Gielen
Thaís T. T. Tweed
Noémi C. van Nie
Tim Lubbers
Jan H. M. B. Stoot
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Colectomy
Colectomy
Colon Cancer
Colon Cancer
Published in: BMC Cancer / Issue 1/2024
Electronic ISSN: 1471-2407
DOI: https://doi.org/10.1186/s12885-023-11803-4

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Abstract

Background

Methods

Results

Conclusions

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