Association of surgical care practices with length of stay and use of clinical protocols after elective bowel resection: results of a national survey

Conor P. Delaney, Anthony J. Senagore, Todd M. Gerkin, Timothy L. Beard, Wendy M. Zingaro, Kenneth J. Tomaszewski, Laura K. Walton, Sara A. Poston

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background: Although management techniques have been proposed to accelerate gastrointestinal recovery after elective bowel resection (BR), most data are derived from single-institution experience. This study assessed the current state of perioperative care for elective BRs and the effect of pathway components on length of stay. Methods: A web-based survey was conducted among surgeons regarding their last elective BR. Results: Among 207 general and 200 colorectal surgeons, 30% practice in hospitals with a perioperative surgical care pathway intended to accelerate gastrointestinal recovery. Pathway components included early ambulation, early diet progression, early nasogastric tube removal/avoidance, and opioid-sparing pain control. Care practices associated with decreased length of stay included laparoscopic technique, early mobilization, early liquids, and antiemetic use to prevent symptoms associated with prolonged postoperative ileus. Conclusions: Few hospitals have pathways but most surgeons likely would implement nationally endorsed guidelines. These data, along with other studies, may lead to well-accepted BR care pathways.

Original languageEnglish (US)
Pages (from-to)299-304
Number of pages6
JournalAmerican Journal of Surgery
Volume199
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

Keywords

  • Bowel resection
  • Clinical pathway
  • Enhanced recovery pathway
  • Perioperative care
  • Postoperative ileus

ASJC Scopus subject areas

  • Surgery

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