Randomized Controlled Trial of Fast-Track Rehabilitation After Elective Colorectal and Small Bowel Resection
Traditionally, patients who received laparoscopic colorectal surgery were treated with the
classical protocol including the use of a naso-gastric tube and starvation for several
postoperative days till the recovery of bowel movement, or bed resting at immediate
postoperative period followed by ward ambulation at the postoperative day 1 or 2. Restarting
the oral alimentation is based on gas or feces reappearance after surgery and usually this
is possible at several days following surgery. However, prolonged starvation might be
uncomfortable for the patient as well as increasing his postoperative hospital stay.
Recently, several studies reported the efficacy of early rehabilitation protocols after
intestinal surgery, showing that early oral alimentation could reduce the length of hospital
stay and cost of hospitalization without significant increase of postoperative
complications, compared to traditional management.
This prospective, randomized study was designed to evaluate the effectiveness of a
postoperative care pathway using rehabilitation with early ambulation and diet for patients
undergoing elective laparoscopic colorectal resection compared with the traditional
In order to conduct this study, patients having a laparoscopic colon resection will be
randomly attributed to enhanced recovery program group or control group, which is divided
based on the postoperative management protocol.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
the Length of Hospital Stay
discharge criteria Tolerance of consecutive 3 soft bland diet Unassisted ambulation No necessity of analgesics Afebrile without major complication Willing to discharge
Sung-Bum Kang, M.D., Ph.D
Seoul National University Bundang Hospital
South Korea: Institutional Review Board