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the introduction of enhanced recovery pathways, a multimodal peri-
operative care approach that focuses on improving a patient's recov-
ery after surgery, says Dr. Delaney. These pathways look at specific
ways to care for a patient before, during and after colorectal surgery,
and have been shown to decrease the amount of time a patient must
spend in a hospital.
Traditionally, says Dr. Delaney, patients were expected to stay in the
hospital for 10 days, were confined to bed rest for 2 of them, and
could not eat or drink for 5 days after surgery. The enhanced recovery
pathway instead asks that patients eat and drink as soon as they're
comfortable and walk within a day of surgery. "This is really turning
things on its head," he says.
While Dr. Delaney uses a specific enhanced recovery pathway for
his hospital, the general idea of quick ambulation and early introduc-
tion of a diet is something that has done away with nearly 2-week
long hospital stays following colectomy procedures. Put simply, Dr.
Anvari says, "All you're waiting for is for patients to be comfortable
and for them to be able to drink something."
The experts say patients should be encouraged to ambulate and
drink something on the same day of surgery, and should be given an
easy-to-digest breakfast the next morning. If they feel comfortable
after that, patients can then move onto a basic diet. Patients should
also be transitioned from IV pain medication to oral pills as soon as
they can tolerate them. It's also important, the experts say, for the
patient to feel ready to go home. "We won't push patients out if they
don't feel comfortable," says Dr. Anvari.
The experts also agree that using these new standards and reducing
length of stay for patients doesn't negatively impact the patient's care.
In fact, studies have suggested that newer standards reduce post-op
complications. Dr. Delaney says that when compared to patients who
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