ERAS in Laparoscopic Surgery for Colorectal Cancer: Risk Factors for Delayed Recovery

Jagiellonian University

Status: Completed

Conditions: Laparoscopy; Colonic Neoplasms; Perioperative Care

Study type: Observational

Funder types: Other

Identifiers

NCT02527967

JagiellonianU-02

Details and patient eligibility

About

Although there is evidence for reducing complication rate and improving recovery after the implementation of Enhanced Recovery After Surgery (ERAS) protocols into colorectal surgery, most published papers include patients undergoing open resections. The aim was to analyse factors affecting recovery and length of stay (LOS) in patients after laparoscopic colorectal surgery for cancer combined with ERAS protocol.

Full description

All patients were operated using laparoscopic surgery, and the perioperative care was based on pre-established ERAS protocol consisting of 13 pre and intraoperative items. Its principles and criteria for discharge from the hospital were based on the ERAS Society Guidelines.

Investigators analysed which of the factors: gender; age; BMI; ASA (American Society of Anaesthesiologists) physical status; type of surgery (colonic resection vs. rectal resection with total mesorectal excision, TME); stage of cancer; distance between the hospital and place of residence; operative time; intraoperative blood loss significantly prolong LOS (primary length of stay, excluding readmissions). Moreover, the compliance with ERAS protocol and its influence on LOS was analysed.

For the purposes of further analyses the entire group of patients was divided into 2 subgroups depending on the length of their hospital stay. On admission every patient received the information about the target length of stay of 4 days. Group 1 consisted of patients whose hospital stay was shorter or equal to the target LOS (≤ 4 days). In group 2 were patients whose hospital stay was longer than 4 days.

Enrollment: 143 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• colorectal cancer
• laparoscopic resection
• perioperative care according to ERAS principles

Exclusion criteria

• Patients submitted initially for open or emergency surgery
• with complex cancer who required multi-organ resection
• patients treated with endoscopic techniques using the hybrid TaTME technique (Transanal Total Mesorectal Excision)

Trial design

143 participants in 2 patient groups

Group 1 (≤4 days)

Description:

Group 1 consisted of patients whose hospital stay was shorter or equal to the target LOS (≤ 4 days).

Group 1 (>4 days)

Description:

In group 2 were patients whose hospital stay was longer than 4 days.