- 作者：Conor P. Delaney ; M.D. ; Ph.D. ; conor.delaney@UHhospitals.org ; Karen Brady ; R.N. ; Donya Woconish ; R.N. ; Stavan P. Parmar ; M.D. ; Bradley J. Champagne ; M.D.
- 关键词：Length of stay ; Colectomy ; Laparoscopic ; Readmission ; Resource utilization
- 刊名：The American Journal of Surgery
- 出版年：2012
- 期刊代码：9_00029610
- 类别：med
- 出版时间：March, 2012
- 卷：203
- 期：3
- 页码：353-356
- 文件大小：144 K
Background
Learning curves and efficiency concerns have slowed the integration of laparoscopy into colorectal practice. We evaluated our experience with laparoscopic colorectal (LC) surgery using enhanced recovery pathways (ERPs).Methods
One thousand consecutive LC procedures performed by 2 surgeons over a 5-year period using previously published, standardized ERPs were assessed.
Results
The mean age was 59, and the mean body mass index was 29.5. Procedures included segmental colectomy (54%), proctectomy (19%), total colectomy (11%), ostomy (5%), and other procedures (11%). Diagnoses included malignancy (41%), diverticulitis (16%), inflammatory bowel disease (13%), and other (30%). The mean operative time was 151 minutes, and the mean blood loss was 55 mL. Conversion to an open surgery occurred in 5.8%, whereas 2.3%were performed using a hand-assist procedure. The mean hospital stay was 4.1 days (median 3), with a 6%readmission rate. Complications (20%) included mortality (0.3%), wound infection (4%), and anastomotic leak (1.4%).
Conclusions
LC surgery with ERP offers excellent outcomes with efficient use of resources.