Case controlled study of the hospital stay and return to full activity following laparoscopic and open colorectal surgery before and after the introduction of an enhanced recovery programme

Abstract

The short-term benefits of laparoscopic surgery are well established and in particular within an enhanced recovery programme. Early return to activity is to be expected but has not been quantified widely. The aim of this study was to measure the hospital stay and return to full activity following laparoscopic colorectal surgery and compare this with a matched group of patients undergoing open colorectal resections before and after the introduction of an enhanced recovery programme. Retrospective analysis of all laparoscopic colorectal operations performed between January 2003 and June 2007 on an intention to treat basis compared with a matched group of patients undergoing elective open colorectal surgery at the same institution. The median hospital stay following 179 laparoscopic colorectal resections was 6 days whilst following 144 conventional open operations it was 8 days. Following the introduction of an enhanced recovery programme the hospital stay fell from 7 to 5 days and from 9 to 7 days for laparoscopic and open groups respectively. The median return to full activity from surgery for laparoscopic patients was 13 days in comparison to 56 days for patients undergoing open colorectal surgery. Following laparoscopic colorectal resection, patients can be expected to have a hospital stay of under a week and return to their usual activities as early as a week after discharge from hospital and < 2 weeks from surgery in comparison to patients undergoing open surgery who take 8 weeks or more to recover.