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 .
Open sphincter-preserving surgery of extraperitoneal rectal cancer without primary stoma and Fast Track Protocol.
AIM Fast track protocol ( FTP ) showed to improve perioperative care . The study aims to evaluate the impact of the FTP in the open extraperitoneal rectal cancer ( ERC ) surgical treatment without a primary derivative stoma ( DS ) and the QoL in patients with or without a secondary DS . PATIENTS AND METHODS 50 patients affected by ERC were enrolled and operated on with open low anterior resection without a primary DS .  They were r and omized in two groups : one was treated perioperativelly in the traditional way ( group T ) , the other using a modif ed FTP ( group FT ) . A QoL question naire was administered prior to discharge and at 1-month follow-up . RESULTS Five courses ( 10 % ) were complicated by anastomotic leakage : 3 ( 12 % ) in the FT group ( 2 minor and 1 maior ) and 2 ( 8 % ) in the T group ( 1 minor and 1 maior ) ( p = n.s . ) . All the maiors and one minor were treated with a DS . Patients of the group FTP were considered dischargeable earlier that those of group T ( p<0.05 ) . Patients with DS had a significantly lower QoL score ( p<0.0001 ) . CONCLUSION FTP with minor modifications is feasible and safe in the ERC open surgery without using a DS . Better results were obtained without increasing complication rate . A secondary DS impacts detrimentally on
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 .