Enhanced Recovery Programme: a faster and safer perioperative course: LTP33


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Abstract

Aim:The Enhanced Recovery Programme (ERP) is an innovative multimodal approach to the perioperative care of elective colorectal resections. By lessening the stress response and expediting a return to normality it aims to shorten hospital stay (therefore lowering costs) without compromising post-operative outcomes. This is especially pertinent given the current economic climate where we must strive to use our finite resources as efficiently as possible.Method:A retrospective observational study was conducted at Basildon University Hospital to: (1) compare patient outcomes before and after introduction of the ERP; (2) compare outcomes of laparoscopic versus openprocedures for ERP patients. Inclusion criteria were all patients undergoing elective colorectal resections between 1992 and February 2010.Results:Sample size = 757 (153 ERP, 604 Non-ERP) patients. The introduction of the ERP has led to a reduced length of stay (ERP 6 days, 95% CI 6-7; Non-ERP 9 days, 95% CI 9-10), but no significant difference between the groups for: anastomotic leak rates (OR 1.3, 95% CI 0.35-4.9), readmission rates (OR 0.88, 95% CI 0.47-1.6) or 30-day mortality (OR 0.82, 95% CI 0.27-2.0).Conclusion:The ERP is a simple and valuable perioperative pathway that reduces length of stay without a deleterious effect on patients.

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