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 Citations (Scopus)

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

Fingerprint

Clinical Protocols
Perioperative Care
Length of Stay
Early Ambulation
Antiemetics
Ileus
Opioid Analgesics
Guidelines
Diet
Pain
Surveys and Questionnaires
Surgeons

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Association of surgical care practices with length of stay and use of clinical protocols after elective bowel resection : results of a national survey. / Delaney, Conor P.; Senagore, Anthony J.; Gerkin, Todd M.; Beard, Timothy L.; Zingaro, Wendy M.; Tomaszewski, Kenneth J.; Walton, Laura K.; Poston, Sara A.

In: American Journal of Surgery, Vol. 199, No. 3, 03.2010, p. 299-304.

Research output: Contribution to journalArticle

Delaney, Conor P. ; Senagore, Anthony J. ; Gerkin, Todd M. ; Beard, Timothy L. ; Zingaro, Wendy M. ; Tomaszewski, Kenneth J. ; Walton, Laura K. ; Poston, Sara A. / Association of surgical care practices with length of stay and use of clinical protocols after elective bowel resection : results of a national survey. In: American Journal of Surgery. 2010 ; Vol. 199, No. 3. pp. 299-304.
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