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To compare the numbers of patients withprolonged hospital stays secondary to delayed independent ileostomy self care following elective anterior resection,prior to and following the introduction ofpreoperative stoma counselling. One aspect of the Enhanced Recovery Programme (ERP) involves extensive patient education regarding the possibility of a stoma following an elective large bowel resection. This involvespreoperative education, comprising a specialist stoma nurse session, information packs and stoma equipment to optimise independent stoma management.Prospective outcome data were recorded for 180 ERP patients from September 2008 including length of stay (LOS) and whether hospital discharge was postponed due to delayed patient management of the stoma. This was compared with retrospectively collected data for 120 patients operated on between January 2006 and August 2008.Prior to ERP, 18% (n = 21) of patients experienced delayed discharge, in contrast to only one patient out of those following ERP.This study has shown the benefits ofpreoperative counselling inpreparing patients for more rapid independent stoma management, maintaining the reduced average LOS with ERP of 8 days in contrast to 14 daysprior to its introduction.