New colorectal surgery guidelines mean quicker recovery

What is the quickest, most effective way to recover from colorectal surgery?

Health Sciences North's surgical program believes the answer could involve allowing patients to eat and drink whatever they want before and after surgery, and getting them moving as quickly as possible.

HSN is implementing new guidelines for patients receiving elective colorectal surgery, including colon and rectal resections.

The new guidelines are being introduced at HSN as part of a provincewide project called iERAS (Implementing an Enhanced Recovery After Surgery), conducted in partnership with the Council of Academic Hospitals of Ontario (CAHO).

HSN is one of 15 hospitals in the province, and the only facility in Northeastern Ontario, taking part in the study.

The new guidelines are applied before, during, and after surgery, and include the following measures:

-Allowing patients to eat whatever they want up to the night before surgery

-Allowing patients to drink liquids two hours prior to surgery

-Eliminating the use of abdominal and nasal drains during surgery

-Removing catheters from colon surgery patients within 24 hours, and from rectal surgery patients within 72 hours.

-Allowing patients to eat whatever they want, as much as they want, the day after surgery

-Encouraging patients to sit up in bed hours after surgery and walk around the day after surgery

-Personal follow-ups with patients 30 days after surgery to check on their progress

“These guidelines have been developed using evidence-based research and have all been proven to work,” said Natalie Lefrançois-Gauvin, HSN project lead for the new protocols.

“All of these measures are designed to improve patient outcomes, reduce length of stay, better patient satisfaction and better facilitate interdisciplinary communication and collaboration.”

The iERAS program has a target hospital length of stay of three to four days for colorectal surgery. Currently, colorectal surgery patients spend an average of 11 days in hospital.

After two years, the iERAS program will be analyzed by the research committee to determine if the measures are successful in reducing recovery times, post-operative complications and hospital re-admissions.

“As a surgeon, I am very happy that we at HSN are implementing these guidelines, which are considered the standard of care in many other places around the world,” said Dr. Antonio Caycedo, a colorectal surgeon and HSN’s surgical lead for the new guidelines.

“iERAS is part of CAHO’s Adopting Research to Improve Care (ARTIC) Program, the goal of which is to foster better collaboration and establish a systematic approach to moving research evidence into practice, in order to drive quality improvement and benefit the health care system as a whole,” said CAHO’s executive director, Karen Michell.

“Congratulations to the team at Health Sciences North. Projects like iERAS are important because they use best evidence to achieve optimal health outcomes for patients.”

“Congratulations to CAHO and the first-rate team here at HSN for moving this project forward for the good of our patients,” said Dr. Denis Roy, HSN’s president and CEO.

“This is another excellent example of how research leads to the highest standards of care, and this is the kind of patient-centred innovation and research we want to foster at HSN.”