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Techniques in Coloproctology

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01-04-2018 | Original Article

Application of an enhanced recovery pathway for ileostomy closure: a case–control trial with surprising results

Authors: J. Slieker, M. Hübner, V. Addor, C. Duvoisin, N. Demartines, D. Hahnloser

Published in: Techniques in Coloproctology | Issue 4/2018

Abstract

Background

Enhanced recovery after surgery (ERAS) protocols have been widely validated in colorectal surgery; however, few data exist on loop ileostomy closure. The aim of this study was to compare clinical outcomes before and after introduction of ERAS for loop ileostomy closure.

Methods

Data on outcomes after loop ileostomy closure were retrospectively collected before ERAS was applied at our department (control group). These results were compared to results of patients undergoing loop ileostomy closure within the original colorectal ERAS pathway (ERAS 1 group); after analysis of these results, adaptations were made to the ERAS pathway regarding the postoperative diet, and this second category of patients was analyzed (ERAS 2 group).

Results

Forty-eight patients in the control group were compared to 46 ERAS 1 and 69 ERAS 2 patients. First stool was significantly faster in ERAS 2 group versus control and ERAS 1 group [median 1 (range 1–2) days vs 2 (2–3) days p value 0.01]. The incidence of vomiting increased from 26% in the control group to 45% in ERAS 1 group, and then decreased to 29% in the ERAS 2 group (p value 0.41). Length of stay was significantly shorter during the ERAS 2 protocol: median 4 (range 3–6) days versus 5 (4–8) days in the control group (p value < 0.01).

Conclusions

After application of the ‘colorectal’ ERAS pathway to loop ileostomy closure, results were initially not improved. Minor corrections were sufficient to avoid increased incidence of vomiting and to allow for reduced hospital stay. Uncritical extrapolation of an ERAS colorectal protocol to other types of surgery should be monitored and needs audit for corrections.

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Title: Application of an enhanced recovery pathway for ileostomy closure: a case–control trial with surprising results
Authors: J. Slieker
M. Hübner
V. Addor
C. Duvoisin
N. Demartines
D. Hahnloser
Publication date: 01-04-2018
Publisher: Springer International Publishing
Published in: Techniques in Coloproctology / Issue 4/2018
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-018-1778-1

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Springer Medicine

Application of an enhanced recovery pathway for ileostomy closure: a case–control trial with surprising results

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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