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![]() ![]() Although different agents were used for bowel cleansing, the rationale behind MBP includes the evacuation of stool to allow visualization of the luminal surfaces and to reduce fecal flora thereby reducing infections and anastomotic leakage after colorectal surgery. For over a century, preoperative MBP has been the standard care in colorectal surgery. One of the main elements of ERAS programs is avoiding routine mechanical bowel preparation (MBP). In a series of 16 open sigmoid colectomies, the authors achieved their aim of a two-day hospital stay in about 60% of the cases. The concept of fast-track (enhanced recovery after surgery, ERAS) was introduced to colorectal surgical practice by Kehlet in 1999 to improve postoperative recovery rates and reduce the length of hospital stay. Subsequent meta-analysis of randomized trials (RCTs) and of non-randomized comparative studies as well as a Cochrane review showed that CLR was associated with faster recovery, lower complication rates and a shorter stay in hospital compared with COR. In a published series of 20 sigmoid resections, the authors achieved their aim of a five-day hospital stay in 70% of the cases. Laparoscopic colorectal resection (CLR) was introduced in 1991 as a proposed less invasive alternative to COR. The current evidence suggests that within such a program, there is no difference between laparoscopic and open colorectal surgery in terms of postoperative recovery rates or length of hospital stay.Ĭonventional open resection (COR) has been reported to be associated with overall morbidity rates of 23% to 30% and an average hospital stay of 10 d (7 to 12 d). The role of laparoscopic surgery in colorectal resections within a fast-track (ERAS) program is controversial. ERAS has been shown to improve postoperative recovery, reduce length of stay and enhance early return to normal function when compared with traditional colorectal surgical protocols. To assess the effect of enhanced recovery after surgery (ERAS) program on postoperative length of stay after elective colorectal resections, a literature review was conducted, supplemented by the results of 111 ERAS colorectal resections at regional NWS Hospital using a protocol based on the Fast Track approach described by Kehlet in 1999. It was later on assessed by multiple randomized controlled trials and meta-analysis and was found to be associated with a faster recovery, lower complication rates and a shorter stay in hospital compared with open resection. ![]() Laparoscopic colorectal resection was first described in 1991 as a minimally invasive form of colorectal surgery. ![]() Colorectal resection was traditionally associated with significant morbidity and prolonged stay in hospital. ![]()
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