Manual of Fast Track Recovery for Colorectal Surgery Enhanced Recovery

Colorectal surgery is a major surgical procedure that can be associated with significant postoperative morbidity. Enhanced recovery (ER) pathways have been developed to reduce complications, shorten hospital stays, and improve patient outcomes. This manual provides a comprehensive guide to the ER pathway for colorectal surgery, based on the latest evidence-based recommendations.

The preoperative phase is crucial for optimizing patient outcomes. Key elements of the ER pathway include:

• Patient education: Patients should be fully informed about the ER pathway and their role in recovery.
• Preoperative assessment: A comprehensive assessment should be performed to identify and optimize any risk factors.
• Nutritional optimization: Patients should be encouraged to maintain a healthy diet and avoid smoking and alcohol intake.
• Prehabilitation: Exercises and other interventions can help improve patients' physical fitness and prepare them for surgery.

The intraoperative phase focuses on minimizing surgical trauma and optimizing tissue perfusion. Key elements include:

Manual of Fast Track Recovery for Colorectal Surgery (Enhanced Recovery Book 0)

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• Minimally invasive techniques: Laparoscopic or robotic-assisted surgery should be used whenever possible.
• Fluid management: Crystalloids should be used for fluid resuscitation, and excessive fluid administration should be avoided.
• Normothermia: Patients should be actively warmed to maintain normothermia during surgery.
• Antimicrobial prophylaxis: Antibiotics should be administered before surgery to prevent infection.

The postoperative phase is the most critical for implementing the ER pathway. Key elements include:

• Early mobilization: Patients should be encouraged to get out of bed and walk as soon as possible after surgery.
• Pain management: Multimodal analgesia should be used to minimize pain and optimize recovery.
• Nutrition: A high-protein, low-carbohydrate diet should be started as soon as possible after surgery.
• Bowel management: Early bowel function should be restored to prevent complications such as ileus.
• Discharge planning: Patients should be discharged from the hospital as soon as their condition is stable.

Numerous studies have shown that the ER pathway for colorectal surgery can improve patient outcomes. Benefits include:

• Shorter hospital stays
• Reduced postoperative complications
• Improved quality of life
• Lower costs

The ER pathway for colorectal surgery is a comprehensive, evidence-based approach to optimizing patient outcomes. By following the recommendations outlined in this manual, surgeons and healthcare providers can help their patients recover faster and experience better outcomes.

• [1] Enhanced Recovery After Surgery for Colorectal Surgery: A Systematic Review and Meta-Analysis. Ann Surg. 2017;265(3):443-452.
• [2] The Enhanced Recovery After Surgery (ERAS) Protocol for Colorectal Surgery: A Review of the Literature. World J Surg. 2018;42(1):1-11.
• [3] Fast-Track Recovery After Colorectal Surgery: A Meta-Analysis of Randomized Controlled Trials. JAMA Surg. 2016;151(1):49-57.

Manual of Fast Track Recovery for Colorectal Surgery (Enhanced Recovery Book 0)

5 out of 5

Language	:	English
File size	:	4572 KB
Text-to-Speech	:	Enabled
Screen Reader	:	Supported
Enhanced typesetting	:	Enabled
Print length	:	194 pages

FREE