Abstract
Background: Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Early postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. However, early mobilization still has various definitions and lacks specific strategies.Methods: Patients who underwent minimally invasive surgery for colorectal cancer followed our perioperative ERAS program, including mobilization from the first postoperative day. After perioperative care skills were improved in our well-established program, compliance, inpatient surgical outcomes, and complications associated with adding smartband use were evaluated and compared with the outcomes for standard protocol. Quality of recovery was evaluated using patient-rated QoR-40 questionnaires the day before surgery, on postoperative days 1 and 3, and on the day of discharge.Results: Smartband use after minimally invasive colorectal surgery failed to increase compliance with early mobilization or reduce the occurrence of postoperative complications significantly compared with standard ERAS protocol. However, when smartbands were utilized, quality of recovery was optimized and patients returned to their preoperative status earlier, at postoperative day 3. The length of hospital stay, as defined by discharge criteria, and hospital stay of patients without complications was reduced by 1.1 and 0.9 days, respectively (P = 0.009 and 0.049, respectively).Conclusions: Smartbands enable enhanced communication between patients and surgical teams and strengthen self-management in patients undergoing minimally invasive colorectal resection surgery. Accelerated recovery to preoperative functional status can be facilitated by integrating smartbands into the process of early mobilization during ERAS.
Highlights
For both malignant and benign diseases, the most common postoperative complications after colorectal surgery are prolonged ileus, pneumonia, difficulty weaning from ventilation, and urinary tract infection
No randomized control trial has supported the direct benefits of postoperative mobilization, prolonged immobilization increases the risk of pneumonia, insulin resistance, and muscle weakness [3]
The aim of this study was to evaluate whether smartbands, which are popular wearable devices, help enhanced recovery after surgery (ERAS) programs and improve recovery in patients who have undergone Minimally invasive surgery (MIS) for colorectal resection
Summary
For both malignant and benign diseases, the most common postoperative complications after colorectal surgery are prolonged ileus, pneumonia, difficulty weaning from ventilation, and urinary tract infection. Invasive surgery (MIS) improves some short-term surgical outcomes (fewer wound infections and lower wound dehiscence rate) and longterm outcomes (fewer early and late postoperative bowel obstructions). In 2010, the ERAS society was founded in Sweden; thereafter, the guidelines for an integrated care pathway for colonic and rectal resection were outlined in 2012. These combined a range of simple evidence-based interventions aimed at improving postoperative recovery for patients after major colorectal surgery. Enhanced recovery after surgery (ERAS) is valuable in perioperative care for its ability to improve short-term surgical outcomes and facilitate patient recuperation after major surgery. Postoperative mobilization is a vital component of the integrated care pathway and is a factor strongly associated with successful outcomes. Early mobilization still has various definitions and lacks specific strategies
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