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Optimizing perioperative management of patients undergoing colorectal surgery: what is new?
Karolinska University Hospital Huddinge, Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm.
Karolinska University Hospital Huddinge, Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm.
Karolinska University Hospital Huddinge, Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm; Department of Surgery, Centre for Gastrointestinal Disease, Ersta Hospital, Stockholm.ORCID iD: 0000-0003-2636-4745
2006 (English)In: Current Opinion in Critical Care, ISSN 1070-5295, E-ISSN 1531-7072, Vol. 12, no 2, p. 166-70Article, review/survey (Refereed) Published
Abstract [en]

Purpose or review: This review highlights recent developments in individual perioperative interventions in colorectal surgery, and progress in so-called fast-track or enhanced-recovery programmes.

Recent findings: A new survey from five northern European countries has revealed that best clinical practice in perioperative care, based on previously published high-grade evidence, is only partially in use in daily clinical practice. Recently, a number of trials contrasting clinical results in enhanced-recovery protocols versus traditional care clearly show that such protocols indeed enhance recovery, although effects on morbidity are less obvious. Further evidence supporting preoperative oral carbohydrate treatment, avoidance of oral bowel preparation and wound drainage in elective colonic surgery and avoidance of intraoperative fluid excess has emerged. The oral opioid antagonist alvimopan has recently been shown to limit postoperative gastrointestinal paralysis. The role of laparoscopic surgery in the era of enhanced-recovery programmes is unclear.

Summary: There is strong evidence on how to enhance recovery after colorectal surgery, but many interventions are not utilized in daily practice. Further evidence has emerged supporting several perioperative treatments, and successful experiences of enhanced-recovery programmes have now been reported from several centres.

Place, publisher, year, edition, pages
Philadelphia, USA: Lippincott Williams & Wilkins, 2006. Vol. 12, no 2, p. 166-70
Keywords [en]
Colorectal surgery, fluid therapy, length of stay, perioperative care, recovery of function
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-40370DOI: 10.1097/01.ccx.0000216586.62125.6dISI: 000237902900017PubMedID: 16543795Scopus ID: 2-s2.0-33645302934OAI: oai:DiVA.org:oru-40370DiVA, id: diva2:777182
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-12-05Bibliographically approved

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