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World Journal of Surgery

Published in:

01-05-2012

Laparoscopic-Assisted and Open High Anterior Resection within an ERAS Protocol

Authors: Ulf O. Gustafsson, Marit Tiefenthal, Anders Thorell, Olle Ljungqvist, Jonas Nygrens

Published in: World Journal of Surgery | Issue 5/2012

Abstract

Background

Due to potentially superior short-term outcomes compared with open colorectal surgery, laparoscopic surgery is currently being implemented in clinical practice worldwide. In parallel, enhanced recovery after surgery (ERAS) programs are shown to improve postoperative recovery in open colorectal surgery. This study reports outcomes in laparoscopic versus open surgery in conjunction with compliance to the ERAS protocol.

Methods

The association between surgical approach (laparoscopic or open surgery), compliance to the ERAS protocol, postoperative symptoms, complications, and length of stay after surgery was studied. Between January 2007 to December 2010, 114 consecutive patients underwent elective high anterior resection with laparoscopic-assisted (n = 55) or open resection (n = 59). All clinical data (114 variables) were prospectively recorded.

Results

The overall preoperative ERAS-protocol compliance was 77% for both the laparoscopic and open group. Laparoscopic surgery resulted in shorter total length of stay (median 4 vs. 6 days, p = 0.04), earlier pain control (median 2 vs. 3 days, p = 0.008), shorter need for intravenous infusions, improved mobilization on the first postoperative day (POD1), and lower inflammatory response (CRP (POD1) 54 ± 24 vs. 67 ± 31 mg/l, p = 0.017) compared with open resection. The trends in fewer postoperative complications (9.1 vs. 16.9%; odds ratio (OR) 0.55; 95% confidence interval (CI) 0.17–1.81) and overall postoperative symptoms delaying recovery (20 vs. 30.5%; OR 0.63; 95% CI 0.22–1.34) in laparoscopic surgery were not statistically significant.

Conclusions

The use of laparoscopy in colorectal surgery within an ERAS protocol results in faster recovery compared with open resection.

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Title: Laparoscopic-Assisted and Open High Anterior Resection within an ERAS Protocol
Authors: Ulf O. Gustafsson
Marit Tiefenthal
Anders Thorell
Olle Ljungqvist
Jonas Nygrens
Publication date: 01-05-2012
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 5/2012
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1519-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic-Assisted and Open High Anterior Resection within an ERAS Protocol

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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