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 .
Optimizing cost and short-term outcomes for elderly patients in laparoscopic colonic surgery
Background Elderly patients often are regarded as high-risk for major abdominal surgery because of a lack of functional reserve and associated medical comorbidities . The goal of this study was to compare the cost of care and short-term outcomes of elderly and nonelderly patients undergoing laparoscopic colectomy .  Our hypothesis was that elderly patients managed with  laparoscopic colorectal surgery and an enhanced recovery protocol ( ERP ) can realize the same benefits of lower hospital length of stay ( LOS ) without increasing hospital costs or readmission rates . Methods Review of a prospect i ve data base identified all patients that underwent an elective laparoscopic colectomy from 2009 to 2012 . Patients were stratified into elderly ( ≥70 years old ) and nonelderly ( < 70 years old ) cohorts . The main outcome measures were discharge disposition , hospital costs , hospital LOS , and 30-day readmission rates between the laparoscopic and open groups . Results A total of 302 nonelderly ( 66 % ) and 153 elderly ( 34 % ) patients were included in the analysis . The elderly cohort had significantly higher comorbidities than the nonelderly group . There were no mortalities . Operative variables ( procedure time , blood loss , and intraoperative complications ) were similar . At discharge , significantly more elderly patients required temporary nursing or home care . There were no significant differences in short-term outcomes of LOS , 30-day readmission rates , or costs for the episode of care between the two groups . Conclusions Combining laparoscopic colectomy with an ERP is cost-effective and results in similar short-term outcomes for the elderly and nonelderly patients . Despite higher comorbidities , elderly patients realized the same benefits of shorter LOS with similar hospital costs and readmission rates
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 .