Early Outcome of Enhanced Recovery Programs Versus Conventional Perioperative Care in Elective Open Left Side Colonic Ca
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ORIGINAL ARTICLE
Early Outcome of Enhanced Recovery Programs Versus Conventional Perioperative Care in Elective Open Left Side Colonic Carcinoma Surgery: Analysis of 80 Cases Emad M. Abd ElRahman 1 & Mohamed S. Kharoub 1 & Ahmed Shora 2 & Nabil A. Emara 3 & M. Ashraf Balbaa 4 Received: 11 June 2019 / Accepted: 1 April 2020 # Indian Association of Surgical Oncology 2020
Abstract According to recent clinical practice guidelines, enhanced recovery programs (ERP) have been practiced to improve surgical outcomes and decrease cost. However, these are still opposed by the traditional measures in the treatment of colorectal carcinoma that is still practiced with the concept of protection of anastomosis and decrease postoperative complications. The aim of this study was to report our experience in ERP in elective open left side colonic carcinoma surgery in comparison with the conventional perioperative care. The current prospective multicenter randomized controlled study included a total of 80 adult patients with left side colonic cancer who were eligible for elective colonic resection. Included patients were randomly divided into two equal groups: group (A) where conventional perioperative care was performed and group (B) where ERP were applied. Followup was designed for at least 1 month to evaluate and compare hospital stay and postoperative complications. There was no statistically significant difference between the two groups as regards demographic data and preoperative comorbidities. There were statistically significant less pain (P = 0.24), less postoperative nausea and vomiting (P = 0.045), and less hospital stay (P < 0.001) in group B than group A. Otherwise, there was no statistically significant difference in comparing the rest of postoperative surgical or non-surgical complications or rates of readmissions between the two groups. ERP are safe, reliable, simple, and applicable in open left side cancer colon surgery with no negative impact over the postoperative complications in comparison with the conventional care. Keywords Left side colon cancer . Enhanced recovery programs . Perioperative care
Introduction Colorectal cancer (CRC) is the third most commonly diagnosed malignancy and the fourth leading cause of cancer death in the world [1]. The colon is split into right and left
* Emad M. Abd ElRahman [email protected] 1
General Surgery Department, Faculty of Medicine, Benha University, Benha, Egypt
2
General Surgery Department, Faculty of Medicine, Tanta University, Tanta, Egypt
3
Department of Anesthesiology, Faculty of Medicine, Benha University, Benha, Egypt
4
General Surgery Department, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt
portions based on the splenic flexure; each part is different in its embryological origin and shows different physiologic features. Accordingly, in different treatment options [2], surgery is the mainstay of treatment of colon cancer, providing definitive management and potential cure in early cases and effective palliation in advanced cases [3].
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