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 journalArticle

    33 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 1 2010

    Keywords

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

    ASJC Scopus subject areas

    • Surgery

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    Delaney, C. P., Senagore, A. J., Gerkin, T. M., Beard, T. L., Zingaro, W. M., Tomaszewski, K. J., Walton, L. K., & Poston, S. A. (2010). Association of surgical care practices with length of stay and use of clinical protocols after elective bowel resection: results of a national survey. American Journal of Surgery, 199(3), 299-304. https://doi.org/10.1016/j.amjsurg.2009.08.027