The fundamental impact of a colectomy enhanced recovery pathway is the increased efficiency provided by guidelines defining the sequencing and timing of interventions. The applicability of the pathway across a broad range of disease pathology and diverse patient populations must be considered and its value assessed across the entire episode of care. The major hurdle that limits the value proposition of an enhanced recovery pathway is successful implementation and maintenance of such pathways across all members participating in patient care. Increasing understanding of the surgical stress response will help us continue to create components within enhanced recovery pathways that will reduce morbidity and effectively reduce cost in management of colorectal patients.
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