{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:07:38Z","timestamp":1787170058606,"version":"build-2736575974"},"reference-count":18,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"\n Introduction:<\/jats:title>\n Enhanced recovery after surgery (ERAS) programmes include pre-operative, intraoperative and post-operative clinical pathways to improve quality of patient care while reducing length of stay (LOS) and readmission. This study assessed the feasibility and outcomes of an ERAS protocol for colorectal surgery implemented over 2 years in a small, resource-challenged rural hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A prospective cohort study used retrospectively matched controls to assess the effect of ERAS on LOS in patients undergoing colorectal surgery in a small rural hospital in northern Ontario, Canada. ERAS patients were matched to two patients in the control group based on diagnosis, age and gender. Patients had open or laparoscopic colorectal surgeries, with those in the intervention group treated per ERAS protocol and given instructions on pre- and post-operative self-care.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Most of the 47 ERAS patients recruited to the study reported adherence to ERAS protocols before surgery. Adherence to protocol was strongest for chewing gum in the days after surgery. Most patients were sitting in a chair for their afternoon meal by the 1\n st<\/jats:sup>\n day and most were walking down the hallway by the 2\n nd<\/jats:sup>\n day. The control group had significantly higher (\n P<\/jats:italic>\n < 0.001) malignant neoplasm of the colon (C18, 69% vs. 35%) and significantly lower malignant neoplasm of the rectum (C20, 0% vs. 5%). The control group had an average ln-transformed LOS that was significantly longer (exponentiated as 1.7 days) than ERAS patients (\n t<\/jats:italic>\n -test,\n P<\/jats:italic>\n < 0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This study found that ERAS could be implemented in a small rural hospital and provided evidence for a reduced LOS of approximately 2 days.<\/jats:p>\n <\/jats:sec>\n \n Introduction:<\/jats:title>\n Les programmes de r\u00e9habilitation am\u00e9lior\u00e9e apr\u00e8s chirurgie (RAAC) comprennent des itin\u00e9raires cliniques pr\u00e9op\u00e9ratoires, perop\u00e9ratoires et postop\u00e9ratoires visant \u00e0 am\u00e9liorer la qualit\u00e9 des soins aux patients tout en r\u00e9duisant la dur\u00e9e du s\u00e9jour et les r\u00e9admissions. Cette \u00e9tude a \u00e9valu\u00e9 la faisabilit\u00e9 et les r\u00e9sultats d\u2019un protocole de RAAC pour la chirurgie colorectale mis en \u0153uvre pendant deux ans dans un petit h\u00f4pital rural aux ressources limit\u00e9es.<\/jats:p>\n <\/jats:sec>\n \n M\u00e9thodes:<\/jats:title>\n Une \u00e9tude de cohorte prospective a utilis\u00e9 des t\u00e9moins appari\u00e9s pour \u00e9valuer l\u2019effet de la RAAC sur la dur\u00e9e du s\u00e9jour des patients subissant une chirurgie colorectale dans un petit h\u00f4pital rural du nord de l\u2019Ontario, au Canada. Les patients RAAC ont \u00e9t\u00e9 appari\u00e9s \u00e0 deux patients du groupe t\u00e9moin sur la base du diagnostic, de l\u2019\u00e2ge et du sexe. Les patients ont subi une chirurgie colorectale ouverte ou laparoscopique, et ceux du groupe d\u2019intervention ont \u00e9t\u00e9 trait\u00e9s selon le protocole de RAAC et ont re\u00e7u des instructions sur les soins auto-administr\u00e9s pr\u00e9 et postop\u00e9ratoires.<\/jats:p>\n <\/jats:sec>\n \n R\u00e9sultats:<\/jats:title>\n \n La plupart des 47 patients RAAC recrut\u00e9s pour l\u2019\u00e9tude ont d\u00e9clar\u00e9 adh\u00e9rer aux protocoles de RAAC avant l\u2019intervention chirurgicale. L\u2019adh\u00e9sion au protocole a \u00e9t\u00e9 la plus forte pour la gomme \u00e0 m\u00e2cher dans les jours qui ont suivi l\u2019op\u00e9ration. La plupart des patients \u00e9taient assis sur une chaise pour le repas de l\u2019apr\u00e8s-midi d\u00e8s le premier jour et la plupart marchaient dans le couloir d\u00e8s le deuxi\u00e8me jour. Le groupe t\u00e9moin pr\u00e9sentait un taux significativement plus \u00e9lev\u00e9 (\n P<\/jats:italic>\n < 0,001) de n\u00e9oplasme malin du c\u00f4lon (C18, 69% contre 35%) et un taux significativement plus faible de n\u00e9oplasme malin du rectum (C20, 0% contre 5%). Le groupe de contr\u00f4le avait une dur\u00e9e moyenne de s\u00e9jour transform\u00e9e en Ln significativement plus longue (exponentielle de 1,7 jours) que les patients RAAC (test\n t<\/jats:italic>\n ,\n P<\/jats:italic>\n < 0,001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Cette \u00e9tude a montr\u00e9 que la RAAC pouvait \u00eatre mise en \u0153uvre dans un petit h\u00f4pital rural et a fourni des preuves d\u2019une r\u00e9duction de la dur\u00e9e de s\u00e9jour d\u2019environ deux jours.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/cjrm.cjrm_71_22","type":"journal-article","created":{"date-parts":[[2023,10,16]],"date-time":"2023-10-16T07:52:07Z","timestamp":1697442727000},"page":"179-189","source":"Crossref","is-referenced-by-count":1,"title":["Enhanced recovery after surgery reduces length of stay after colorectal surgery in a small rural hospital in Ontario"],"prefix":"10.4103","volume":"28","author":[{"given":"Hector A.","family":"Roldan","sequence":"first","affiliation":[{"name":"Chief of Surgery, Department of Surgery, Muskoka Algonquin Healthcare, Associate Professor Northern Ontario School of Medicine University, Sudbury, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Robert","family":"Brown","sequence":"additional","affiliation":[{"name":"Chief of Surgery, Department of Surgery, Muskoka Algonquin Healthcare, Associate Professor Northern Ontario School of Medicine University, Sudbury, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Radey","sequence":"additional","affiliation":[{"name":"Chief of Surgery, Muskoka Algonquin Healthcare, Huntsville, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Hogenbirk","sequence":"additional","affiliation":[{"name":"Northern Ontario School of Medicine, Centre for Rural and Northern Health Research, Laurentian University, Sudbury, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa Rosalie","family":"Allen","sequence":"additional","affiliation":[{"name":"Huntsville Physicians, Parry Sound, South Muskoka Local Education Groups Local Education Group, Huntsville, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10,17]]},"reference":[{"key":"R1-20231019","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jclinane.2018.12.034","article-title":"Enhanced recovery after surgery in colorectal surgery:Impact of protocol adherence on patient outcomes","volume":"55","author":"Arrick","year":"2019","journal-title":"J Clin Anesth"},{"key":"R2-20231019","doi-asserted-by":"crossref","first-page":"E469","DOI":"10.1503\/cmaj.180635","article-title":"Enhanced recovery after surgery:Implementing a new standard of surgical care","volume":"191","author":"Altman","year":"2019","journal-title":"CMAJ"},{"key":"R3-20231019","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s00384-013-1802-x","article-title":"Enhanced recovery strategies in colorectal surgery:Is the compliance with the whole program required to achieve the target?","volume":"29","author":"Gianotti","year":"2014","journal-title":"Int J Colorectal Dis"},{"key":"R4-20231019","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1007\/s00384-016-2621-7","article-title":"Enhanced recovery care after colorectal surgery in elderly patients. 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