Reduced protocol compliance was the most frequently identified modifiable predictive factor for adverse LOS , morbidity and readmission .
Conclusion Protocol compliance is the most frequently reported predictive factor for outcomes of ERAS programmes following laparoscopic colorectal resection .
Reduced compliance increases LOS , morbidity and readmission to hospital .
The impact of compliance with individual ERAS protocol elements is insufficiently studied , and the lack of a st and ardised framework for evaluating ERAS programmes makes it difficult to draw definite conclusions about which factors exert the greatest impact on outcome after laparoscopic colorectal resection
Objective To perform a systematic review of published literature for the factors reported to predict outcomes of enhanced recovery after surgery ( ERAS ) programmes following  laparoscopic colorectal surgery .
Background ERAS programmes and the use of laparoscopy have been widely adopted in colorectal surgery bringing short-term patient benefit .
However , there is a minority of patients that do not benefit from these strategies and their identification is not well characterised .
The factors that underpin outcomes from ERAS programmes for laparoscopic patients are not understood .
Predicting who will fail early discharge after laparoscopic colorectal surgery with an established enhanced recovery pathway
Background Despite using laparoscopy and enhanced recovery pathways ( ERP ) , some patients are not ready for early discharge . The goal of this study was to identify predictors for patients who might fail early discharge , so that any defined factors might be addressed and optimized . Methods A prospect ively maintained data base was review ed for major elective laparoscopic colorectal surgical procedures . Cases were divided into day of discharge groups : ≤3 days and > 4 days . All followed a st and ardized ERP . Demographic and clinical data were compared using Student ’s paired t tests or Fisher ’s exact test , with p value < 0.05 statistically significant . Regression analysis was performed to identify significant variables . Results There were 275 ≤3 days patients and 273 > 4 days patients . There were significant differences between groups in body mass index ( p = 0.0123 ) , comorbidities ( p = 0.0062 ) , ASA class ( p = 0.0014 ) , operation time ( p < 0.001 ) , postoperative complications ( p < 0.001 ) , and 30-day reoperation rate ( p = 0.0004 ) . There were no significant differences for intraoperative complications ( p = 0.724 ) , readmissions ( p = 0.187 ) , or mortality rate ( p = 1.00 ) . Significantly more patients were discharged directly home in the ≤3-days cohort . Using logistic regression , every hour of operating time increased the risk of length of stay > 4 days by 2.35 % . Conclusions Elective colorectal surgery patients with longer operation times and more comorbidities are more likely to fail early discharge . These patients should have different expectations of the ERP , as an expected 1- to 3-day stay may not be achievable . By identifying patients at risk for failing early discharge , re sources and postoperative support can be better allocated and patients better informed about likely recovery
Reduced protocol compliance was the most frequently identified modifiable predictive factor for adverse LOS , morbidity and readmission .
Conclusion Protocol compliance is the most frequently reported predictive factor for outcomes of ERAS programmes following laparoscopic colorectal resection .
Reduced compliance increases LOS , morbidity and readmission to hospital .
The impact of compliance with individual ERAS protocol elements is insufficiently studied , and the lack of a st and ardised framework for evaluating ERAS programmes makes it difficult to draw definite conclusions about which factors exert the greatest impact on outcome after laparoscopic colorectal resection
Objective To perform a systematic review of published literature for the factors reported to predict outcomes of enhanced recovery after surgery ( ERAS ) programmes following  laparoscopic colorectal surgery .
Background ERAS programmes and the use of laparoscopy have been widely adopted in colorectal surgery bringing short-term patient benefit .
However , there is a minority of patients that do not benefit from these strategies and their identification is not well characterised .
The factors that underpin outcomes from ERAS programmes for laparoscopic patients are not understood .