TY - JOUR
T1 - Standardized postoperative pathway
T2 - Accelerating recovery after ileostomy closure
AU - Joh, Yong Geul
AU - Lindsetmo, Rolv Ole
AU - Stulberg, Jonah
AU - Obias, Vincent
AU - Champagne, Brad
AU - Delaney, Conor P.
PY - 2008/12
Y1 - 2008/12
N2 - PURPOSE: In this study we evaluated the outcome of a standardized enhanced recovery program in patients undergoing ileostomy closure. METHODS: Forty-two patients underwent ileostomy closure by a single surgeon and were managed by a standardized postoperative care pathway. On the first postoperative day, patients received oral analgesia and a soft diet. Discharge was based on standard criteria previously published for laparoscopic colectomy patients. Results were recorded prospectively in an Institutional Review Board-approved database, including demographics, operative time, blood loss, complications, length of stay, and readmission data. RESULTS: The median operative time and blood loss were 60 minutes and 17.5 mL, respectively, and median hospital stay was 2 days. Twenty-nine patients (69 percent) were discharged by postoperative Day 2. The complication rate was 23.8 percent; complications included prolonged postoperative ileus (n=3), early postoperative small-bowel obstruction (n=1), mortality not related to ileostomy closure (n=1), minor bleeding (n=1), wound infection (n=1), incisional hernia (n=1), diarrhea (n=1), dehydration (n=1). The 30-day readmission rate was 9.5 percent (n=4). Two patients had reoperation within 30 days for small-bowel obstruction and a wound infection. CONCLUSIONS: Ileostomy closure patients managed with postoperative care pathways can have a short hospital stay with acceptable morbidity and readmission rates.
AB - PURPOSE: In this study we evaluated the outcome of a standardized enhanced recovery program in patients undergoing ileostomy closure. METHODS: Forty-two patients underwent ileostomy closure by a single surgeon and were managed by a standardized postoperative care pathway. On the first postoperative day, patients received oral analgesia and a soft diet. Discharge was based on standard criteria previously published for laparoscopic colectomy patients. Results were recorded prospectively in an Institutional Review Board-approved database, including demographics, operative time, blood loss, complications, length of stay, and readmission data. RESULTS: The median operative time and blood loss were 60 minutes and 17.5 mL, respectively, and median hospital stay was 2 days. Twenty-nine patients (69 percent) were discharged by postoperative Day 2. The complication rate was 23.8 percent; complications included prolonged postoperative ileus (n=3), early postoperative small-bowel obstruction (n=1), mortality not related to ileostomy closure (n=1), minor bleeding (n=1), wound infection (n=1), incisional hernia (n=1), diarrhea (n=1), dehydration (n=1). The 30-day readmission rate was 9.5 percent (n=4). Two patients had reoperation within 30 days for small-bowel obstruction and a wound infection. CONCLUSIONS: Ileostomy closure patients managed with postoperative care pathways can have a short hospital stay with acceptable morbidity and readmission rates.
KW - Hospital stay
KW - Ileostomy closure
KW - Postoperative ileus
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U2 - 10.1007/s10350-008-9399-9
DO - 10.1007/s10350-008-9399-9
M3 - Article
C2 - 18575937
AN - SCOPUS:56349085473
VL - 51
SP - 1786
EP - 1789
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
SN - 0012-3706
IS - 12
ER -