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 .
Intravenous Lidocaine Versus Thoracic Epidural Analgesia: A Randomized Controlled Trial in Patients Undergoing Laparoscopic Colorectal Surgery Using an Enhanced Recovery Program
Background and Objective : Laparoscopy , thoracic epidural analgesia , and enhanced recovery program ( ERP ) have been shown to be the major elements to facilitate the postoperative recovery strategy in open colorectal surgery . This study compared the effect of intraoperative and postoperative intravenous ( IV ) lidocaine infusion with thoracic epidural analgesia on postoperative restoration of bowel function in patients undergoing laparoscopic colorectal resection using an ERP . Methods : Sixty patients scheduled for elective laparoscopic colorectal surgery were prospect ively r and omized to receive either thoracic epidural analgesia ( TEA group ) or IV lidocaine infusion ( IL group ) ( 1 mg/kg per hour ) with patient-controlled analgesia morphine for the first 48 hours after surgery . All patients received a similar ERP . The primary outcome was time to return of bowel function . Postoperative pain intensity , time out of bed , dietary intake , duration of hospital stay , and postoperative complications were also recorded . Results : Mean times and SD ( 95 % confidence interval ) to first flatus ( TEA , 24 [ SD , 11 ] [ 19 - 29 ] hrs vs IL , 27 [ SD , 12 ] [ 22 - 32 ] hrs ) and to bowel movements ( TEA , 44 ±19 [ 35 - 52 ] hrs vs IL , 43 [ SD , 20 ] [ 34 - 51 ] hrs ) were similar in both groups ( P = 0.887 ) . Thoracic epidural analgesia provided better analgesia in patients undergoing rectal surgery . Time out of bed and dietary intake were similar . Patients in the TEA and IL groups were discharged on median day 3 ( interquartile range , 3 - 4 days ) , P = 0.744 . Sixty percent of patients in both groups left the hospital on day 3 . Conclusions : Intraoperative and postoperative IV infusion of lidocaine in patients undergoing laparoscopic colorectal resection using an ERP had a similar impact on bowel function compared with thoracic epidural analgesia
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 .