How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?

Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first imple...

Ausführliche Beschreibung

Gespeichert in:

Bibliographische Detailangaben
Veröffentlicht in:	The surgeon (Edinburgh) 2018-12, Vol.16 (6), p.321-324
Hauptverfasser:	Veziant, Julie, Leonard, Daniel, Pereira, Bruno, Slim, Karem, Alfonsi, P., Andre, A., Atger, J., Auvray, S., Bongiovanni, J.P., Boumadani, M., Bozio, G., Brek, A., Catinois, M.L., Chambirer, G., Chokairi, S., Chopin Laly, X., Cotte, E., De la Fontaine, C., Denet, C., Dileon, S., Douard, R., Dupré, A., Fernoux, Ph, Gergeanu, S., Gignoux, B., Hail, K., Joris, J., Laporte, S., Leporrier, J., Mauvais, F., Meillat, H., Michaud, Ph, Mor Martinez, C., Ostermann Bucher, S., Peluchon, Ph, Pichot-Delahaye, V., Plard, L., Raspado, O., Regimbeau, J.M., Riboud, R., Tavernier, M., Tete, B., Thievenaz, R., Venara, A., Voilin, C., Vuagnat, C.
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Clinical Protocols Colectomy Colorectal surgery Elective Surgical Procedures Enhanced recovery Female Humans Length of Stay Male Middle Aged Perioperative Care Program Evaluation Recovery of Function Rectum - surgery Retrospective Studies Sustainability Time Factors Treatment Outcome
Online-Zugang:	Volltext
Tags:	Tag hinzufügen Keine Tags, Fügen Sie den ersten Tag hinzu!

container_end_page	324
container_issue	6
container_start_page	321
container_title	The surgeon (Edinburgh)
container_volume	16
creator	Veziant, Julie Leonard, Daniel Pereira, Bruno Slim, Karem Alfonsi, P. Andre, A. Atger, J. Auvray, S. Bongiovanni, J.P. Boumadani, M. Bozio, G. Brek, A. Catinois, M.L. Chambirer, G. Chokairi, S. Chopin Laly, X. Cotte, E. De la Fontaine, C. Denet, C. Dileon, S. Douard, R. Dupré, A. Fernoux, Ph Gergeanu, S. Gignoux, B. Hail, K. Joris, J. Laporte, S. Leporrier, J. Mauvais, F. Meillat, H. Michaud, Ph Mor Martinez, C. Ostermann Bucher, S. Peluchon, Ph Pichot-Delahaye, V. Plard, L. Raspado, O. Regimbeau, J.M. Riboud, R. Tavernier, M. Tete, B. Thievenaz, R. Venara, A. Voilin, C. Vuagnat, C.
description	Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation. Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage. 2565 patients with a mean age of 63.6 ± 14.4 years from 63 colorectal centers were included. There were 1853 (72.2%) colectomies and 558 (21.7%) rectal resections. The median duration of hospital stay was 5 days [Interquartiles 4–8]. Overall morbidity was 21.9%, surgical morbidity was 8.1%, including 2.8% anastomotic fistulae. Overall, the ERP component most often applied with was postoperative nasogastric tube omission (93.6%), followed by laparoscopic approach (81.7%), absence of drainage (74.9%), and colonic preparation omission (67.3%). Implementation of surgical components significantly decreased over time: less laparoscopy (from 86.8% to 76.6%, p
doi_str_mv	10.1016/j.surge.2018.03.003
format	Article
fullrecord	<record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2027069590</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1479666X18300374</els_id><sourcerecordid>2027069590</sourcerecordid><originalsourceid>FETCH-LOGICAL-c359t-63a2e041973083ec6973a964c23330b3f343c74f1fb2f21e49a57e88793ec1043</originalsourceid><addsrcrecordid>eNp9kElLNDEQhoN8ouPyCwTJ0Uu3laWXHERE3EDwouAtZDLVY4buTpv0jPjvTTvq8TtVKvW8tbyEnDDIGbDyfJXHdVhizoHVOYgcQOyQGZdQZEUt4R-ZMVmprCzL131yEOMKgBcCij2yz1X6BYAZ2dz7D7rwGOn4htQMQ-usGZ3vqW_o1D-lLbW-G3yP_Rip6yn2b6a3uKABrd9g-KRD8MtgukgbHxLc-lQZk-57wVS3SbBEOsF0dB1eHpHdxrQRj3_iIXm5vXm-vs8en-4erq8eMysKNWalMBxBMlUJqAXaMj2MKqXlQgiYi0ZIYSvZsGbOG85QKlNUWNeVSjADKQ7J2bZv2vB9jXHUnYsW29b06NdRc-AVlKpQkFCxRW3wMQZs9BBcZ8KnZqAnw_VKf9-jJ8M1CJ0MT6rTnwHreYeLP82vwwm42AKYztw4DDpah5N9bjJJL7z774Av2A6T5w</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2027069590</pqid></control><display><type>article</type><title>How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Veziant, Julie ; Leonard, Daniel ; Pereira, Bruno ; Slim, Karem ; Alfonsi, P. ; Andre, A. ; Atger, J. ; Auvray, S. ; Bongiovanni, J.P. ; Boumadani, M. ; Bozio, G. ; Brek, A. ; Catinois, M.L. ; Chambirer, G. ; Chokairi, S. ; Chopin Laly, X. ; Cotte, E. ; De la Fontaine, C. ; Denet, C. ; Dileon, S. ; Douard, R. ; Dupré, A. ; Fernoux, Ph ; Gergeanu, S. ; Gignoux, B. ; Hail, K. ; Joris, J. ; Laporte, S. ; Leporrier, J. ; Mauvais, F. ; Meillat, H. ; Michaud, Ph ; Mor Martinez, C. ; Ostermann Bucher, S. ; Peluchon, Ph ; Pichot-Delahaye, V. ; Plard, L. ; Raspado, O. ; Regimbeau, J.M. ; Riboud, R. ; Tavernier, M. ; Tete, B. ; Thievenaz, R. ; Venara, A. ; Voilin, C. ; Vuagnat, C.</creator><creatorcontrib>Veziant, Julie ; Leonard, Daniel ; Pereira, Bruno ; Slim, Karem ; Alfonsi, P. ; Andre, A. ; Atger, J. ; Auvray, S. ; Bongiovanni, J.P. ; Boumadani, M. ; Bozio, G. ; Brek, A. ; Catinois, M.L. ; Chambirer, G. ; Chokairi, S. ; Chopin Laly, X. ; Cotte, E. ; De la Fontaine, C. ; Denet, C. ; Dileon, S. ; Douard, R. ; Dupré, A. ; Fernoux, Ph ; Gergeanu, S. ; Gignoux, B. ; Hail, K. ; Joris, J. ; Laporte, S. ; Leporrier, J. ; Mauvais, F. ; Meillat, H. ; Michaud, Ph ; Mor Martinez, C. ; Ostermann Bucher, S. ; Peluchon, Ph ; Pichot-Delahaye, V. ; Plard, L. ; Raspado, O. ; Regimbeau, J.M. ; Riboud, R. ; Tavernier, M. ; Tete, B. ; Thievenaz, R. ; Venara, A. ; Voilin, C. ; Vuagnat, C. ; French speaking Group for Enhanced Recovery after Surgery (GRACE)</creatorcontrib><description>Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation. Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage. 2565 patients with a mean age of 63.6 ± 14.4 years from 63 colorectal centers were included. There were 1853 (72.2%) colectomies and 558 (21.7%) rectal resections. The median duration of hospital stay was 5 days [Interquartiles 4–8]. Overall morbidity was 21.9%, surgical morbidity was 8.1%, including 2.8% anastomotic fistulae. Overall, the ERP component most often applied with was postoperative nasogastric tube omission (93.6%), followed by laparoscopic approach (81.7%), absence of drainage (74.9%), and colonic preparation omission (67.3%). Implementation of surgical components significantly decreased over time: less laparoscopy (from 86.8% to 76.6%, p < 0.001), less drain omission (from 88.7% to 72%, p < 0.001), less nasogastric tube omission (from 100% to 93.4%, p = 0.002) and less colonic preparation omission (from 73.6% to 65.6%, p = 0.01). This large-scale study found that implementation of surgical components in ERP decreased over time. Further efforts are needed to sustain compliance with ERP and surgical teams should focus on repeated audits.</description><identifier>ISSN: 1479-666X</identifier><identifier>EISSN: 2405-5840</identifier><identifier>DOI: 10.1016/j.surge.2018.03.003</identifier><identifier>PMID: 29666000</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Aged ; Clinical Protocols ; Colectomy ; Colorectal surgery ; Elective Surgical Procedures ; Enhanced recovery ; Female ; Humans ; Length of Stay ; Male ; Middle Aged ; Perioperative Care ; Program Evaluation ; Recovery of Function ; Rectum - surgery ; Retrospective Studies ; Sustainability ; Time Factors ; Treatment Outcome</subject><ispartof>The surgeon (Edinburgh), 2018-12, Vol.16 (6), p.321-324</ispartof><rights>2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland</rights><rights>Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-63a2e041973083ec6973a964c23330b3f343c74f1fb2f21e49a57e88793ec1043</citedby><cites>FETCH-LOGICAL-c359t-63a2e041973083ec6973a964c23330b3f343c74f1fb2f21e49a57e88793ec1043</cites><orcidid>0000-0002-1527-4691</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1479666X18300374$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29666000$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Veziant, Julie</creatorcontrib><creatorcontrib>Leonard, Daniel</creatorcontrib><creatorcontrib>Pereira, Bruno</creatorcontrib><creatorcontrib>Slim, Karem</creatorcontrib><creatorcontrib>Alfonsi, P.</creatorcontrib><creatorcontrib>Andre, A.</creatorcontrib><creatorcontrib>Atger, J.</creatorcontrib><creatorcontrib>Auvray, S.</creatorcontrib><creatorcontrib>Bongiovanni, J.P.</creatorcontrib><creatorcontrib>Boumadani, M.</creatorcontrib><creatorcontrib>Bozio, G.</creatorcontrib><creatorcontrib>Brek, A.</creatorcontrib><creatorcontrib>Catinois, M.L.</creatorcontrib><creatorcontrib>Chambirer, G.</creatorcontrib><creatorcontrib>Chokairi, S.</creatorcontrib><creatorcontrib>Chopin Laly, X.</creatorcontrib><creatorcontrib>Cotte, E.</creatorcontrib><creatorcontrib>De la Fontaine, C.</creatorcontrib><creatorcontrib>Denet, C.</creatorcontrib><creatorcontrib>Dileon, S.</creatorcontrib><creatorcontrib>Douard, R.</creatorcontrib><creatorcontrib>Dupré, A.</creatorcontrib><creatorcontrib>Fernoux, Ph</creatorcontrib><creatorcontrib>Gergeanu, S.</creatorcontrib><creatorcontrib>Gignoux, B.</creatorcontrib><creatorcontrib>Hail, K.</creatorcontrib><creatorcontrib>Joris, J.</creatorcontrib><creatorcontrib>Laporte, S.</creatorcontrib><creatorcontrib>Leporrier, J.</creatorcontrib><creatorcontrib>Mauvais, F.</creatorcontrib><creatorcontrib>Meillat, H.</creatorcontrib><creatorcontrib>Michaud, Ph</creatorcontrib><creatorcontrib>Mor Martinez, C.</creatorcontrib><creatorcontrib>Ostermann Bucher, S.</creatorcontrib><creatorcontrib>Peluchon, Ph</creatorcontrib><creatorcontrib>Pichot-Delahaye, V.</creatorcontrib><creatorcontrib>Plard, L.</creatorcontrib><creatorcontrib>Raspado, O.</creatorcontrib><creatorcontrib>Regimbeau, J.M.</creatorcontrib><creatorcontrib>Riboud, R.</creatorcontrib><creatorcontrib>Tavernier, M.</creatorcontrib><creatorcontrib>Tete, B.</creatorcontrib><creatorcontrib>Thievenaz, R.</creatorcontrib><creatorcontrib>Venara, A.</creatorcontrib><creatorcontrib>Voilin, C.</creatorcontrib><creatorcontrib>Vuagnat, C.</creatorcontrib><creatorcontrib>French speaking Group for Enhanced Recovery after Surgery (GRACE)</creatorcontrib><title>How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?</title><title>The surgeon (Edinburgh)</title><addtitle>Surgeon</addtitle><description>Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation. Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage. 2565 patients with a mean age of 63.6 ± 14.4 years from 63 colorectal centers were included. There were 1853 (72.2%) colectomies and 558 (21.7%) rectal resections. The median duration of hospital stay was 5 days [Interquartiles 4–8]. Overall morbidity was 21.9%, surgical morbidity was 8.1%, including 2.8% anastomotic fistulae. Overall, the ERP component most often applied with was postoperative nasogastric tube omission (93.6%), followed by laparoscopic approach (81.7%), absence of drainage (74.9%), and colonic preparation omission (67.3%). Implementation of surgical components significantly decreased over time: less laparoscopy (from 86.8% to 76.6%, p < 0.001), less drain omission (from 88.7% to 72%, p < 0.001), less nasogastric tube omission (from 100% to 93.4%, p = 0.002) and less colonic preparation omission (from 73.6% to 65.6%, p = 0.01). This large-scale study found that implementation of surgical components in ERP decreased over time. Further efforts are needed to sustain compliance with ERP and surgical teams should focus on repeated audits.</description><subject>Aged</subject><subject>Clinical Protocols</subject><subject>Colectomy</subject><subject>Colorectal surgery</subject><subject>Elective Surgical Procedures</subject><subject>Enhanced recovery</subject><subject>Female</subject><subject>Humans</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Perioperative Care</subject><subject>Program Evaluation</subject><subject>Recovery of Function</subject><subject>Rectum - surgery</subject><subject>Retrospective Studies</subject><subject>Sustainability</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>1479-666X</issn><issn>2405-5840</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kElLNDEQhoN8ouPyCwTJ0Uu3laWXHERE3EDwouAtZDLVY4buTpv0jPjvTTvq8TtVKvW8tbyEnDDIGbDyfJXHdVhizoHVOYgcQOyQGZdQZEUt4R-ZMVmprCzL131yEOMKgBcCij2yz1X6BYAZ2dz7D7rwGOn4htQMQ-usGZ3vqW_o1D-lLbW-G3yP_Rip6yn2b6a3uKABrd9g-KRD8MtgukgbHxLc-lQZk-57wVS3SbBEOsF0dB1eHpHdxrQRj3_iIXm5vXm-vs8en-4erq8eMysKNWalMBxBMlUJqAXaMj2MKqXlQgiYi0ZIYSvZsGbOG85QKlNUWNeVSjADKQ7J2bZv2vB9jXHUnYsW29b06NdRc-AVlKpQkFCxRW3wMQZs9BBcZ8KnZqAnw_VKf9-jJ8M1CJ0MT6rTnwHreYeLP82vwwm42AKYztw4DDpah5N9bjJJL7z774Av2A6T5w</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Veziant, Julie</creator><creator>Leonard, Daniel</creator><creator>Pereira, Bruno</creator><creator>Slim, Karem</creator><creator>Alfonsi, P.</creator><creator>Andre, A.</creator><creator>Atger, J.</creator><creator>Auvray, S.</creator><creator>Bongiovanni, J.P.</creator><creator>Boumadani, M.</creator><creator>Bozio, G.</creator><creator>Brek, A.</creator><creator>Catinois, M.L.</creator><creator>Chambirer, G.</creator><creator>Chokairi, S.</creator><creator>Chopin Laly, X.</creator><creator>Cotte, E.</creator><creator>De la Fontaine, C.</creator><creator>Denet, C.</creator><creator>Dileon, S.</creator><creator>Douard, R.</creator><creator>Dupré, A.</creator><creator>Fernoux, Ph</creator><creator>Gergeanu, S.</creator><creator>Gignoux, B.</creator><creator>Hail, K.</creator><creator>Joris, J.</creator><creator>Laporte, S.</creator><creator>Leporrier, J.</creator><creator>Mauvais, F.</creator><creator>Meillat, H.</creator><creator>Michaud, Ph</creator><creator>Mor Martinez, C.</creator><creator>Ostermann Bucher, S.</creator><creator>Peluchon, Ph</creator><creator>Pichot-Delahaye, V.</creator><creator>Plard, L.</creator><creator>Raspado, O.</creator><creator>Regimbeau, J.M.</creator><creator>Riboud, R.</creator><creator>Tavernier, M.</creator><creator>Tete, B.</creator><creator>Thievenaz, R.</creator><creator>Venara, A.</creator><creator>Voilin, C.</creator><creator>Vuagnat, C.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1527-4691</orcidid></search><sort><creationdate>201812</creationdate><title>How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?</title><author>Veziant, Julie ; Leonard, Daniel ; Pereira, Bruno ; Slim, Karem ; Alfonsi, P. ; Andre, A. ; Atger, J. ; Auvray, S. ; Bongiovanni, J.P. ; Boumadani, M. ; Bozio, G. ; Brek, A. ; Catinois, M.L. ; Chambirer, G. ; Chokairi, S. ; Chopin Laly, X. ; Cotte, E. ; De la Fontaine, C. ; Denet, C. ; Dileon, S. ; Douard, R. ; Dupré, A. ; Fernoux, Ph ; Gergeanu, S. ; Gignoux, B. ; Hail, K. ; Joris, J. ; Laporte, S. ; Leporrier, J. ; Mauvais, F. ; Meillat, H. ; Michaud, Ph ; Mor Martinez, C. ; Ostermann Bucher, S. ; Peluchon, Ph ; Pichot-Delahaye, V. ; Plard, L. ; Raspado, O. ; Regimbeau, J.M. ; Riboud, R. ; Tavernier, M. ; Tete, B. ; Thievenaz, R. ; Venara, A. ; Voilin, C. ; Vuagnat, C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-63a2e041973083ec6973a964c23330b3f343c74f1fb2f21e49a57e88793ec1043</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Clinical Protocols</topic><topic>Colectomy</topic><topic>Colorectal surgery</topic><topic>Elective Surgical Procedures</topic><topic>Enhanced recovery</topic><topic>Female</topic><topic>Humans</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Perioperative Care</topic><topic>Program Evaluation</topic><topic>Recovery of Function</topic><topic>Rectum - surgery</topic><topic>Retrospective Studies</topic><topic>Sustainability</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Veziant, Julie</creatorcontrib><creatorcontrib>Leonard, Daniel</creatorcontrib><creatorcontrib>Pereira, Bruno</creatorcontrib><creatorcontrib>Slim, Karem</creatorcontrib><creatorcontrib>Alfonsi, P.</creatorcontrib><creatorcontrib>Andre, A.</creatorcontrib><creatorcontrib>Atger, J.</creatorcontrib><creatorcontrib>Auvray, S.</creatorcontrib><creatorcontrib>Bongiovanni, J.P.</creatorcontrib><creatorcontrib>Boumadani, M.</creatorcontrib><creatorcontrib>Bozio, G.</creatorcontrib><creatorcontrib>Brek, A.</creatorcontrib><creatorcontrib>Catinois, M.L.</creatorcontrib><creatorcontrib>Chambirer, G.</creatorcontrib><creatorcontrib>Chokairi, S.</creatorcontrib><creatorcontrib>Chopin Laly, X.</creatorcontrib><creatorcontrib>Cotte, E.</creatorcontrib><creatorcontrib>De la Fontaine, C.</creatorcontrib><creatorcontrib>Denet, C.</creatorcontrib><creatorcontrib>Dileon, S.</creatorcontrib><creatorcontrib>Douard, R.</creatorcontrib><creatorcontrib>Dupré, A.</creatorcontrib><creatorcontrib>Fernoux, Ph</creatorcontrib><creatorcontrib>Gergeanu, S.</creatorcontrib><creatorcontrib>Gignoux, B.</creatorcontrib><creatorcontrib>Hail, K.</creatorcontrib><creatorcontrib>Joris, J.</creatorcontrib><creatorcontrib>Laporte, S.</creatorcontrib><creatorcontrib>Leporrier, J.</creatorcontrib><creatorcontrib>Mauvais, F.</creatorcontrib><creatorcontrib>Meillat, H.</creatorcontrib><creatorcontrib>Michaud, Ph</creatorcontrib><creatorcontrib>Mor Martinez, C.</creatorcontrib><creatorcontrib>Ostermann Bucher, S.</creatorcontrib><creatorcontrib>Peluchon, Ph</creatorcontrib><creatorcontrib>Pichot-Delahaye, V.</creatorcontrib><creatorcontrib>Plard, L.</creatorcontrib><creatorcontrib>Raspado, O.</creatorcontrib><creatorcontrib>Regimbeau, J.M.</creatorcontrib><creatorcontrib>Riboud, R.</creatorcontrib><creatorcontrib>Tavernier, M.</creatorcontrib><creatorcontrib>Tete, B.</creatorcontrib><creatorcontrib>Thievenaz, R.</creatorcontrib><creatorcontrib>Venara, A.</creatorcontrib><creatorcontrib>Voilin, C.</creatorcontrib><creatorcontrib>Vuagnat, C.</creatorcontrib><creatorcontrib>French speaking Group for Enhanced Recovery after Surgery (GRACE)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The surgeon (Edinburgh)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Veziant, Julie</au><au>Leonard, Daniel</au><au>Pereira, Bruno</au><au>Slim, Karem</au><au>Alfonsi, P.</au><au>Andre, A.</au><au>Atger, J.</au><au>Auvray, S.</au><au>Bongiovanni, J.P.</au><au>Boumadani, M.</au><au>Bozio, G.</au><au>Brek, A.</au><au>Catinois, M.L.</au><au>Chambirer, G.</au><au>Chokairi, S.</au><au>Chopin Laly, X.</au><au>Cotte, E.</au><au>De la Fontaine, C.</au><au>Denet, C.</au><au>Dileon, S.</au><au>Douard, R.</au><au>Dupré, A.</au><au>Fernoux, Ph</au><au>Gergeanu, S.</au><au>Gignoux, B.</au><au>Hail, K.</au><au>Joris, J.</au><au>Laporte, S.</au><au>Leporrier, J.</au><au>Mauvais, F.</au><au>Meillat, H.</au><au>Michaud, Ph</au><au>Mor Martinez, C.</au><au>Ostermann Bucher, S.</au><au>Peluchon, Ph</au><au>Pichot-Delahaye, V.</au><au>Plard, L.</au><au>Raspado, O.</au><au>Regimbeau, J.M.</au><au>Riboud, R.</au><au>Tavernier, M.</au><au>Tete, B.</au><au>Thievenaz, R.</au><au>Venara, A.</au><au>Voilin, C.</au><au>Vuagnat, C.</au><aucorp>French speaking Group for Enhanced Recovery after Surgery (GRACE)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?</atitle><jtitle>The surgeon (Edinburgh)</jtitle><addtitle>Surgeon</addtitle><date>2018-12</date><risdate>2018</risdate><volume>16</volume><issue>6</issue><spage>321</spage><epage>324</epage><pages>321-324</pages><issn>1479-666X</issn><eissn>2405-5840</eissn><abstract>Enhanced recovery programs (ERP) improve post-operative outcomes in proportion to how fully they are implemented. Maintaining an optimal level of application of all the ER components is thus essential. Our aim was to assess the sustainability of ER surgical components 2 years after their first implementation. Patients undergoing elective colorectal resections were included in a prospective database. To retrospectively analyze compliance with ERP over a period of 24 months, the following components were considered: colonic preparation, surgical approach, nasogastric tube omission and absence of abdominal drainage. 2565 patients with a mean age of 63.6 ± 14.4 years from 63 colorectal centers were included. There were 1853 (72.2%) colectomies and 558 (21.7%) rectal resections. The median duration of hospital stay was 5 days [Interquartiles 4–8]. Overall morbidity was 21.9%, surgical morbidity was 8.1%, including 2.8% anastomotic fistulae. Overall, the ERP component most often applied with was postoperative nasogastric tube omission (93.6%), followed by laparoscopic approach (81.7%), absence of drainage (74.9%), and colonic preparation omission (67.3%). Implementation of surgical components significantly decreased over time: less laparoscopy (from 86.8% to 76.6%, p < 0.001), less drain omission (from 88.7% to 72%, p < 0.001), less nasogastric tube omission (from 100% to 93.4%, p = 0.002) and less colonic preparation omission (from 73.6% to 65.6%, p = 0.01). This large-scale study found that implementation of surgical components in ERP decreased over time. Further efforts are needed to sustain compliance with ERP and surgical teams should focus on repeated audits.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>29666000</pmid><doi>10.1016/j.surge.2018.03.003</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0002-1527-4691</orcidid></addata></record>
fulltext	fulltext
identifier	ISSN: 1479-666X
ispartof	The surgeon (Edinburgh), 2018-12, Vol.16 (6), p.321-324
issn	1479-666X 2405-5840
language	eng
recordid	cdi_proquest_miscellaneous_2027069590
source	MEDLINE; Elsevier ScienceDirect Journals Complete
subjects	Aged Clinical Protocols Colectomy Colorectal surgery Elective Surgical Procedures Enhanced recovery Female Humans Length of Stay Male Middle Aged Perioperative Care Program Evaluation Recovery of Function Rectum - surgery Retrospective Studies Sustainability Time Factors Treatment Outcome
title	How does the application of surgical components in enhanced recovery programs for colorectal surgery change over time?
url	https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T07%3A20%3A08IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=How%20does%20the%20application%20of%20surgical%20components%20in%20enhanced%20recovery%20programs%20for%20colorectal%20surgery%20change%20over%20time?&rft.jtitle=The%20surgeon%20(Edinburgh)&rft.au=Veziant,%20Julie&rft.aucorp=French%20speaking%20Group%20for%20Enhanced%20Recovery%20after%20Surgery%20(GRACE)&rft.date=2018-12&rft.volume=16&rft.issue=6&rft.spage=321&rft.epage=324&rft.pages=321-324&rft.issn=1479-666X&rft.eissn=2405-5840&rft_id=info:doi/10.1016/j.surge.2018.03.003&rft_dat=%3Cproquest_cross%3E2027069590%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2027069590&rft_id=info:pmid/29666000&rft_els_id=S1479666X18300374&rfr_iscdi=true