Advantages of fast-track recovery after laparoscopic right hemicolectomy for colon cancer

Vassiliki L. Tsikitis, Stefan D. Holubar, Eric Dozois, Robert R. Cima, John H. Pemberton, David Larson

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Fast-track (FT) recovery protocols have demonstrated advantages over historical recovery routines after open colectomy; however, their impact in recovery after laparoscopic colectomy is not clearly defined. This study was designed to determine whether patients who recover on FT protocol after laparoscopic colectomy have a shorter length of stay (LOS) and fewer complications compared with patients who recover on standard (non-FT) protocol. Methods: A cohort of consecutive patients with colon cancer who underwent completed laparoscopic-assisted right hemicolectomy from 2005-2007 was identified. Univariate and multivariate logistic analyses were performed to identify risk factors for increased LOS and postoperative complications with recovery protocol as the primary predictor. Results: A total of 197 patients were included: 115 (58%) patients recovered on a non-FT protocol, and 82 (42%) patients on FT protocol. Univariate analysis showed no differences with respect to age, gender, body mass index, or American Society of Anesthesiologists (ASA) class between groups. The median (interquartile range) LOS was 4 (range, 3-6) days and 3 (range, 3-4) days for the non-FT and FT recovery patients, respectively (p < 0.001). On multivariate analysis, independent risk factors for increased LOS were complications (p < 0.001) and non-FT recovery (p = 0.007). Non-FT recovery also was associated with increased complications (56 vs. 29%, p = 0.0002); this remained significant on multivariate analysis (p < 0.001). Readmissions were similar (p = 1.0) between recovery groups. No mortalities were observed at 30 days. Conclusions: Fast-track recovery is independently associated with a shorter LOS and decreased morbidity after laparoscopic right hemicolectomy.

Original languageEnglish (US)
Pages (from-to)1911-1916
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume24
Issue number8
DOIs
StatePublished - Aug 2010

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Colonic Neoplasms
Length of Stay
Colectomy
Multivariate Analysis
Body Mass Index
Morbidity
Mortality

Keywords

  • Colon cancer
  • Enhanced recovery
  • Fast-track recovery
  • Laparoscopic colectomy

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Advantages of fast-track recovery after laparoscopic right hemicolectomy for colon cancer. / Tsikitis, Vassiliki L.; Holubar, Stefan D.; Dozois, Eric; Cima, Robert R.; Pemberton, John H.; Larson, David.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 24, No. 8, 08.2010, p. 1911-1916.

Research output: Contribution to journalArticle

Tsikitis, Vassiliki L. ; Holubar, Stefan D. ; Dozois, Eric ; Cima, Robert R. ; Pemberton, John H. ; Larson, David. / Advantages of fast-track recovery after laparoscopic right hemicolectomy for colon cancer. In: Surgical Endoscopy and Other Interventional Techniques. 2010 ; Vol. 24, No. 8. pp. 1911-1916.
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abstract = "Background: Fast-track (FT) recovery protocols have demonstrated advantages over historical recovery routines after open colectomy; however, their impact in recovery after laparoscopic colectomy is not clearly defined. This study was designed to determine whether patients who recover on FT protocol after laparoscopic colectomy have a shorter length of stay (LOS) and fewer complications compared with patients who recover on standard (non-FT) protocol. Methods: A cohort of consecutive patients with colon cancer who underwent completed laparoscopic-assisted right hemicolectomy from 2005-2007 was identified. Univariate and multivariate logistic analyses were performed to identify risk factors for increased LOS and postoperative complications with recovery protocol as the primary predictor. Results: A total of 197 patients were included: 115 (58{\%}) patients recovered on a non-FT protocol, and 82 (42{\%}) patients on FT protocol. Univariate analysis showed no differences with respect to age, gender, body mass index, or American Society of Anesthesiologists (ASA) class between groups. The median (interquartile range) LOS was 4 (range, 3-6) days and 3 (range, 3-4) days for the non-FT and FT recovery patients, respectively (p < 0.001). On multivariate analysis, independent risk factors for increased LOS were complications (p < 0.001) and non-FT recovery (p = 0.007). Non-FT recovery also was associated with increased complications (56 vs. 29{\%}, p = 0.0002); this remained significant on multivariate analysis (p < 0.001). Readmissions were similar (p = 1.0) between recovery groups. No mortalities were observed at 30 days. Conclusions: Fast-track recovery is independently associated with a shorter LOS and decreased morbidity after laparoscopic right hemicolectomy.",
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AU - Tsikitis, Vassiliki L.

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AU - Dozois, Eric

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AU - Pemberton, John H.

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N2 - Background: Fast-track (FT) recovery protocols have demonstrated advantages over historical recovery routines after open colectomy; however, their impact in recovery after laparoscopic colectomy is not clearly defined. This study was designed to determine whether patients who recover on FT protocol after laparoscopic colectomy have a shorter length of stay (LOS) and fewer complications compared with patients who recover on standard (non-FT) protocol. Methods: A cohort of consecutive patients with colon cancer who underwent completed laparoscopic-assisted right hemicolectomy from 2005-2007 was identified. Univariate and multivariate logistic analyses were performed to identify risk factors for increased LOS and postoperative complications with recovery protocol as the primary predictor. Results: A total of 197 patients were included: 115 (58%) patients recovered on a non-FT protocol, and 82 (42%) patients on FT protocol. Univariate analysis showed no differences with respect to age, gender, body mass index, or American Society of Anesthesiologists (ASA) class between groups. The median (interquartile range) LOS was 4 (range, 3-6) days and 3 (range, 3-4) days for the non-FT and FT recovery patients, respectively (p < 0.001). On multivariate analysis, independent risk factors for increased LOS were complications (p < 0.001) and non-FT recovery (p = 0.007). Non-FT recovery also was associated with increased complications (56 vs. 29%, p = 0.0002); this remained significant on multivariate analysis (p < 0.001). Readmissions were similar (p = 1.0) between recovery groups. No mortalities were observed at 30 days. Conclusions: Fast-track recovery is independently associated with a shorter LOS and decreased morbidity after laparoscopic right hemicolectomy.

AB - Background: Fast-track (FT) recovery protocols have demonstrated advantages over historical recovery routines after open colectomy; however, their impact in recovery after laparoscopic colectomy is not clearly defined. This study was designed to determine whether patients who recover on FT protocol after laparoscopic colectomy have a shorter length of stay (LOS) and fewer complications compared with patients who recover on standard (non-FT) protocol. Methods: A cohort of consecutive patients with colon cancer who underwent completed laparoscopic-assisted right hemicolectomy from 2005-2007 was identified. Univariate and multivariate logistic analyses were performed to identify risk factors for increased LOS and postoperative complications with recovery protocol as the primary predictor. Results: A total of 197 patients were included: 115 (58%) patients recovered on a non-FT protocol, and 82 (42%) patients on FT protocol. Univariate analysis showed no differences with respect to age, gender, body mass index, or American Society of Anesthesiologists (ASA) class between groups. The median (interquartile range) LOS was 4 (range, 3-6) days and 3 (range, 3-4) days for the non-FT and FT recovery patients, respectively (p < 0.001). On multivariate analysis, independent risk factors for increased LOS were complications (p < 0.001) and non-FT recovery (p = 0.007). Non-FT recovery also was associated with increased complications (56 vs. 29%, p = 0.0002); this remained significant on multivariate analysis (p < 0.001). Readmissions were similar (p = 1.0) between recovery groups. No mortalities were observed at 30 days. Conclusions: Fast-track recovery is independently associated with a shorter LOS and decreased morbidity after laparoscopic right hemicolectomy.

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KW - Laparoscopic colectomy

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