In predefined subgroup analyses , findings did not vary by surgical approach ( open vs laparoscopic ) or colorectal condition .
CONCLUSIONS : Enhanced recovery protocol s for adults undergoing colorectal surgery improve patient outcomes with no increase in adverse events .
Evidence was insufficient regarding which components , or component combinations , are key to improving patient outcomes .
BACKGROUND : Enhanced surgical recovery protocol s are design ed to reduce hospital length of stay and health care costs .
OBJECTIVE : This study aims to systematic ally review and summarize evidence from r and omized and controlled clinical trials comparing enhanced recovery protocol s versus usual care in  adults undergoing elective colorectal surgery with emphasis on recent trials , protocol components , and subgroups for surgical approach and colorectal condition .
Fast-Track Versus Standard Care in Laparoscopic High Anterior Resection: A Prospective Randomized-Controlled Trial
The value of fast-track ( FT ) multimodal recovery programs in improving hospitalization of surgical patients has been widely proved . The application of FT protocol s to laparoscopic colorectal surgery seems to maximize the effects of the minimally invasive approach . The objectives of this r and omized-controlled trial are to compare the short-term outcomes ( bowel function , return to oral nutrition , day of discharge , fatigue , time to resume normal activities , functional capabilities , and readmission rate ) of patients undergoing elective laparoscopic high anterior resection ( HAR ) following either a FT or a st and ard program . The prospect i ve r and omized-controlled trial included 52 consecutive patients undergoing elective laparoscopic HAR . Group 1 was treated with a FT rehabilitation program , and group 2 was treated with a st and ard care ( SC ) program . Patients were interviewed 14 and 30 days postoperatively . One patient in each group was excluded from the study . Mean hospital stay , time of first bowel movement , and bowel function resumption were significantly shorter in the FT group ( P<0.05 ) . Patients in the FT group referred more pain in day 0 versus patients in the SC group ( P<0.05 ) even though the difference disappeared from day 1 . Fatigue was significantly reduced at day 14 in the FT group compared with the SC group ( P<0.01 ) . Similarly , ability to resume the normal preoperative attitude ( walking stairs , cooking , housekeeping , shopping , and walking outdoors ) was significantly better at day 14 in the FT group ( P<0.005 ) . There was no significant difference between the 2 groups at day 30 for the same parameters . There were no readmissions in both the groups and no need for consultations from general practitioners . FT multimodal program is a safe approach effective on postoperative short-term outcome significantly reducing hospital stay . Early postoperative pain control needs to be optimized
In predefined subgroup analyses , findings did not vary by surgical approach ( open vs laparoscopic ) or colorectal condition .
CONCLUSIONS : Enhanced recovery protocol s for adults undergoing colorectal surgery improve patient outcomes with no increase in adverse events .
Evidence was insufficient regarding which components , or component combinations , are key to improving patient outcomes .
BACKGROUND : Enhanced surgical recovery protocol s are design ed to reduce hospital length of stay and health care costs .
OBJECTIVE : This study aims to systematic ally review and summarize evidence from r and omized and controlled clinical trials comparing enhanced recovery protocol s versus usual care in  adults undergoing elective colorectal surgery with emphasis on recent trials , protocol components , and subgroups for surgical approach and colorectal condition .