Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2013 Sep;26(3):139-45.
doi: 10.1055/s-0033-1351128.

Perioperative protocols in colorectal surgery

Mia Debarros  1 , Scott R Steele  1
Affiliations
Review

Perioperative protocols in colorectal surgery

Mia Debarros et al. Clin Colon Rectal Surg. 2013 Sep.

Abstract

The reduction in health-care expenditures and more efficient use of medical resources are now overriding health policy priorities with the two-pronged goal of improving patient outcomes while decreasing overall cost. Current reports show colorectal surgery accounting for 25% of all operative complications and an average length of stay of 8 to 12 days for a standard elective colon resection. To combat this, Kehlet and colleagues introduced a concept of enhanced recovery after surgery (ERAS) or fast-track pathways, with the goal of using current evidence and multimodal therapies to decrease surgical stress, enhance postoperative recovery, and reduce length of stay. The benefits, safety, and cost-effectiveness of fast-track protocols are validated in multiple randomized controlled trials. In this review, the authors focus on the evidence regarding fast-track pathways, use of minimally invasive surgery and its role in fast-track pathways, newer perioperative interventions, and future directions.

Keywords: ERAS; colorectal surgery; enhanced recovery after surgery; fast-track surgery; perioperative protocols.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group . Baltimore, MD: U.S. Department of Commerce and U.S. Bureau of the Census; 2012. U.S. Department of Commerce, Bureau of Economic Analysis; and U.S. Bureau of the Census. National Healthcare Expenditures Data.
    1. The Commonwealth Fund Commission on a High Performance Health System. The path to a high performance health system: a 2020 vision and the policies to pave the way Available at: http://www.commonwealthfund.org. Accessed October 10, 2012
    1. Schilling P L, Dimick J B, Birkmeyer J D. Prioritizing quality improvement in general surgery. J Am Coll Surg. 2008;207:698–704. - PubMed
    1. Longo W E, Virgo K S, Johnson F E. et al.Risk factors for morbidity and mortality after colectomy for colon cancer. Dis Colon Rectum. 2000;43(1):83–91. - PubMed
    1. Adamina M, Kehlet H, Tomlinson G A, Senagore A J, Delaney C P. Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery. Surgery. 2011;149(6):830–840. - PubMed