The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice
<b>AIM:</b> The ERAS protocol consists of multiple items that aim to improve the outcomes of patients receiving surgery. Adhering to the protocol is difficult. We wondered whether surgeons practicing the ERAS protocol in a group would improve patient outcomes. <b>Methods:</b>...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/6992 |
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| author | Zhen-Hao Yu Yih-Jong Chern Yu-Jen Hsu Bor-Kang Jong Wen-Sy Tsai Pao-Shiu Hsieh Ching-Chung Cheng Jeng-Fu You |
| author_facet | Zhen-Hao Yu Yih-Jong Chern Yu-Jen Hsu Bor-Kang Jong Wen-Sy Tsai Pao-Shiu Hsieh Ching-Chung Cheng Jeng-Fu You |
| author_sort | Zhen-Hao Yu |
| collection | DOAJ |
| description | <b>AIM:</b> The ERAS protocol consists of multiple items that aim to improve the outcomes of patients receiving surgery. Adhering to the protocol is difficult. We wondered whether surgeons practicing the ERAS protocol in a group would improve patient outcomes. <b>Methods:</b> All patients who underwent colorectal resection for benign disease or malignancy from November 2017 to December 2018 were collected and reviewed retrospectively. According to the physician’s ward round strategy, the patients were categorized into two groups, either by solo practice or group practice. <b>Results:</b> This study enrolled 724 patients and divided them into two groups according to the practice method: group practice (<i>n</i> = 256) and solo practice (<i>n</i> = 468). The group practice cohort had less postoperative morbidity (14.0% vs. 21.4%, <i>p</i> = 0.048) and shorter postoperative hospital stays (mean: 6.6 ± 3.2 vs. 8.6 ± 5.5, <i>p</i> < 0.05) than the solo practice cohort. Group practice (<i>p</i> < 0.001), natural orifice specimen extraction (NOSE) procedure (<i>p</i> < 0.001), and blood loss >50 mL (<i>p</i> = 0.039) significantly affected discharge within 5 days postoperatively in multivariate analyses. <b>Conclusions:</b> Group practice based on a modified ERAS protocol shortens postoperative hospital stays with fewer morbidities compared with solo practice in which patients receive elective minimally invasive colorectal surgery. |
| first_indexed | 2024-03-09T17:43:47Z |
| format | Article |
| id | doaj.art-9cc46ad82159427a8ea397c4b715583f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:43:47Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9cc46ad82159427a8ea397c4b715583f2023-11-24T11:21:06ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123699210.3390/jcm11236992The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo PracticeZhen-Hao Yu0Yih-Jong Chern1Yu-Jen Hsu2Bor-Kang Jong3Wen-Sy Tsai4Pao-Shiu Hsieh5Ching-Chung Cheng6Jeng-Fu You7Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, TaiwanDivision of Colon and Rectal Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Linkou, Taoyuan 33305, Taiwan<b>AIM:</b> The ERAS protocol consists of multiple items that aim to improve the outcomes of patients receiving surgery. Adhering to the protocol is difficult. We wondered whether surgeons practicing the ERAS protocol in a group would improve patient outcomes. <b>Methods:</b> All patients who underwent colorectal resection for benign disease or malignancy from November 2017 to December 2018 were collected and reviewed retrospectively. According to the physician’s ward round strategy, the patients were categorized into two groups, either by solo practice or group practice. <b>Results:</b> This study enrolled 724 patients and divided them into two groups according to the practice method: group practice (<i>n</i> = 256) and solo practice (<i>n</i> = 468). The group practice cohort had less postoperative morbidity (14.0% vs. 21.4%, <i>p</i> = 0.048) and shorter postoperative hospital stays (mean: 6.6 ± 3.2 vs. 8.6 ± 5.5, <i>p</i> < 0.05) than the solo practice cohort. Group practice (<i>p</i> < 0.001), natural orifice specimen extraction (NOSE) procedure (<i>p</i> < 0.001), and blood loss >50 mL (<i>p</i> = 0.039) significantly affected discharge within 5 days postoperatively in multivariate analyses. <b>Conclusions:</b> Group practice based on a modified ERAS protocol shortens postoperative hospital stays with fewer morbidities compared with solo practice in which patients receive elective minimally invasive colorectal surgery.https://www.mdpi.com/2077-0383/11/23/6992colorectal cancerenhanced recovery after surgerygroup practiceminimally invasive surgery |
| spellingShingle | Zhen-Hao Yu Yih-Jong Chern Yu-Jen Hsu Bor-Kang Jong Wen-Sy Tsai Pao-Shiu Hsieh Ching-Chung Cheng Jeng-Fu You The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice Journal of Clinical Medicine colorectal cancer enhanced recovery after surgery group practice minimally invasive surgery |
| title | The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice |
| title_full | The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice |
| title_fullStr | The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice |
| title_full_unstemmed | The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice |
| title_short | The Nuts and Bolts of Implementing a Modified ERAS Protocol for Minimally Invasive Colorectal Surgery: Group Practice vs. Solo Practice |
| title_sort | nuts and bolts of implementing a modified eras protocol for minimally invasive colorectal surgery group practice vs solo practice |
| topic | colorectal cancer enhanced recovery after surgery group practice minimally invasive surgery |
| url | https://www.mdpi.com/2077-0383/11/23/6992 |
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