Colorectal Surgery

How to save lives in Colorectal Surgery

View Video >

What is Colorectal Surgery?

Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon.

Colorectal surgical disorders include:

  • varicosities or swelling, and inflammation of veins in the rectum and anus (Hemorrhoids)
  • unnatural cracks or tears in the anus (Anal fissures)
  • abnormal connections or passageways between the rectum or other anorectal area to the skin surface (Fistulas)
  • severe constipation conditions
  • fecal incontinence
  • protrusion of the walls of the rectum through the anus (Rectal prolapse)
  • birth defects such as the imperforate anus
  • treatment of severe colic disorders, such as Crohn’s disease
  • cancer of the colon and rectum (Colorectal cancer)
  • repositioning of the rectal area if fallen out.
  • anal cancer (rare)
  • any injuries to the anus
  • removal of objects inserted into anus

 

https://en.wikipedia.org/wiki/Colorectal_surgery

Reduced LOS in colorectal surgery after ERP implementation

Enhanced recovery after surgery (ERAS) is a multimodal approach to perioperative care that combines a range of interventions to enable early mobilisation and feeding after surgery. The feasibility, clinical effectiveness, and cost savings of an ERAS program were investigated at a major US teaching hospital.

Data were collected from consecutive patients undergoing open or laparoscopic colorectal surgery during 2 time periods, before and after implementation of an ERAS protocol. Data collected included patient demographics, operative, and peri-operative surgical and anesthesia data, need for analgesics, complications, inpatient medical costs, and 30-day readmission rates.

 

 

Outcome showed LOS reduced by 2 days (7 to 5)

“There were 99 patients in the traditional care group, and 142 in the ERAS group. The median length of stay (LOS) was 5 days in the ERAS group compared with 7 days in the traditional group (P < 0.001).”

LiDCOrapid as part of an enhanced recovery program (ERAS).

  1. Miller T, Thacker J, White W, Mantyh C, et al. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg 2014;118:1052–6160.

ERAS patients had fewer UTI’s

“ERAS patients had fewer urinary tract infections (13% vs 24%, P = 0.03).”

LiDCOrapid as part of an enhanced recovery program (ERAS).

2. Miller T, Thacker J, White W, Mantyh C, et al. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg 2014;118:1052–6160.

 

 

ERAS decreased re-admission rates

“Readmission rates were lower in ERAS patients (9.8% vs 20.2%, P = 0.02).”

LiDCOrapid as part of an enhanced recovery

  1. Miller T, Thacker J, White W, Mantyh C, et al. Reduced length of hospital stay in colorectal surgery after implementation of an enhanced recovery protocol. Anesth Analg 2014;118:1052–6160.

Hemodynamic monitoring and its financial benefits 

“GDT is cost effective and was associated with cost savings.”

LiDCOplus oxygen delivery (DO2) Early goal-directed therapy (EGDT) target.

4. Ebm C, Cecconi M, Sutton L, et al. A cost-effectiveness analysis of postoperative goal-directed therapy for high-risk surgical patients. Crit Care Med. 2014;42:1194-203 

 

ASCRS SAGES recommend

“In high-risk patients and in patients undergoing major colorectal surgery associated with significant intravascular losses, the use of goal-directed fluid therapy is recommended.”

Several meta-analyses of RCTs have shown that goal-directed fluid therapy (GDFT) reduces postoperative morbidity and length of hospital stay, especially in high-risk patients undergoing major surgery.

5.  Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, Boutros M, McClane J, Feldman LS, Steele SR. Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Dis Colon Rectum. 2017 Aug; 60(8):761-784. PMID: 28682962

Click below to download the Colorectal Surgery infographic

Want to find out how LiDCO can work for you?

Learn about our NEW monitor

Privacy Preference Center

Close your account?

Your account will be closed and all data will be permanently deleted and cannot be recovered. Are you sure?