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 .
Short-term quality of life in patients undergoing colonic surgery using enhanced recovery after surgery program versus conventional perioperative management
Objective Enhanced recovery after surgery ( ERAS ) integrates evidence -based interventions to reduce surgical stress and accelerate rehabilitation . Our study was to compare the short-term quality of life ( QOL ) in patients undergoing open colonic surgery using ERAS program or conventional management .  Methods A prospect i ve study of 57 patients using ERAS program and 60 patients using conventional management was conducted . The clinical characteristics of all patients were recorded . QOL was evaluated longitudinally using the question naires ( EORTC QLQ-C30 and QLQ-CR29 ) pre- and postoperatively . Generalized estimating equation was used to do the analysis in order to determine the effective impact of correlative factors on the postoperative QOL , including age , sex , BMI , ASA grade , tumor location , tumor size , pTNM stage , recovery program and length of time after surgery . Results The morbidity in ERAS and control group was 17.5 versus 26.7 % ( p = 0.235 ) . The patients in ERAS group had much faster rehabilitation and less hospital stay . In the primary statistical analysis , the scores of global QOL ( on POD3 , POD6 , POD10 , POD14 , POD21 ) , physical functioning ( on POD3 , POD6 , POD10 , POD14 , POD21 ) , role functioning ( on POD6 , POD10 , POD14 , POD21 ) , emotional functioning ( on POD3 , POD6 , POD10 , POD14 , POD21 ) , cognitive functioning ( on POD3 , POD6 ) and social functioning ( on POD3 , POD6 , POD10 , POD14 , POD21 , POD28 ) were higher in ERAS group than in control group , which suggested that the patients in ERAS group had a better life status . However , the scores of pain ( on POD10 , POD14 , POD21 ) , appetite loss ( on POD3 , POD6 ) , constipation ( on POD3 , POD6 , POD10 ) , diarrhea ( on POD3 , POD10 ) , financial difficulties ( on POD10 , POD14 , POD21 ) , perspective of future health ( on POD6 , POD10 , POD14 ) , gastrointestinal tract problems ( on POD3 , POD6 , POD10 ) and defecation problems ( on POD6 , POD10 , POD14 ) were lower in ERAS group than in control group , which revealed that the patients in ERAS group suffered less symptoms . In the further generalized estimating equation analysis , the result showed that recovery program and length of time after surgery had independently positive impact on the patient ’s postoperative QOL . ConclusionS hort-term QOL in patients undergoing colonic cancer using ERAS program was better than that using conventional management
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 .