Annals of Coloproctology

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Malignant disease, Functional outcomes,Postoperative outcome & ERAS

Improved outcomes with implementation of an Enhanced Recovery After Surgery pathway for patients undergoing elective colorectal surgery in the Philippines: Mayou Martin T. Tampo, Mark Augustine S. Onglao, Marc Paul J. Lopez, Marie Dione P. Sacdalan, Ma. Concepcion L. Cruz, Rosielyn T. Apellido, Hermogenes J. Monroy III; Ann Coloproctol. 2022;38(2):109-116. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.09.02

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10 Web of Science
10 Citations

Purpose
This study aims to evaluate surgical outcomes (i.e. length of stay [LOS], 30-day morbidity, mortality, reoperation, and readmission rates) with the use of the Enhanced Recovery After Surgery (ERAS) pathway, and determine its association with the rate of compliance to the different ERAS components.
Methods
This was a prospective cohort of patients, who underwent the following elective procedures: stoma reversal (SR), colon resection (CR), and rectal resection (RR). The primary endpoint was to determine the association of compliance to an ERAS pathway and surgical outcomes. These were then retrospectively compared to outcomes prior to the implementation of ERAS.
Results
A total of 267 patients were included in the study. The overall compliance to the ERAS component was 92.0% (SR, 91.8%; CR, 93.1%; RR, 90.7%). There was an associated decrease in morbidity rates across all types of surgery, as compliance to ERAS increased. The average total LOS decreased in all groups but was only found to have statistical significance in SR (12.1±6.7 days vs. 10.0±5.4 days, P=0.002) and RR (19.9±11.4 days vs. 16.9±10.5 days, P=0.04) groups. Decreased postoperative LOS was noted in all groups. Morbidity rates were significantly higher after ERAS implementation, but reoperation and mortality rates were found to be similar.
Conclusion
Increased compliance to ERAS protocol is associated with a decrease in morbidity across all surgery types. The implementation of an ERAS protocol significantly decreased mean hospital LOS, without any increase in major surgical complications. Having your own hospital ERAS pathway improves documentation and accuracy of reporting surgical complications.

Citations

Citations to this article as recorded by

Enhanced Recovery Pathway and Postoperative Ileus After Elective Minimally Invasive Colorectal Surgery
Codruta Craciun, Jenel Marian Patrascu, Danut Dejeu, Ana-Maria Davidoiu-Salavastru, Adrian Cosmin Ilie, Patricia Octavia Mazilu, Lavinia Craciun, Stelian Pantea
Journal of Clinical Medicine.2026; 15(10): 3895. CrossRef
A cost comparison between patients undergoing robotic colorectal surgery with and without a clinical pathway
Alfonso Valenzuela Hurtado, Onur Bayram, Jörg Kleeff, Johannes Klose, Manuela De Allegri, Ulrich Ronellenfitsch
Cost Effectiveness and Resource Allocation.2026;[Epub] CrossRef
Enhanced recovery after surgery (ERAS) in stoma reversal surgery: a systematic review and meta-analysis
Túlio Pimentel, Dante L. S. Souza, Ivonne Zuniga, Maria Clara Faveri, Julia Canfild, Paula Motta Pauperio, Hamza Guend
Updates in Surgery.2025; 77(2): 297. CrossRef
Surgical Enhanced Recovery: Where Are We Now?
Anika Tahmeed, Juan P. Cata, Tong J. Gan
International Anesthesiology Clinics.2025; 63(2): 62. CrossRef
Lessons following implementation of a colorectal enhanced recovery after surgery (ERAS) protocol in a rural hospital setting
Stephen Tolmay, Jamie‐Lee Rahiri, Kim Snoep, Gillian Fewster, Rachel Kee, Yukai Lim, Bridget Watson, Konrad Klaus Richter
ANZ Journal of Surgery.2024; 94(5): 910. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Influence of additional prophylactic oral antibiotics during mechanical bowel preparation on surgical site infection in patients receiving colorectal surgery
Hayoung Lee, Jong Lyul Lee, Ji Sung Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok‐Byung Lim
World Journal of Surgery.2024; 48(6): 1534. CrossRef
Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review
Ji Hyeong Song, Minsung Kim
The Ewha Medical Journal.2024;[Epub] CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park
The Ewha Medical Journal.2023;[Epub] CrossRef

Benign GI diease,Benign diesease & IBD,Complication

High Compliance With Surgical Site Infection (SSI) Prevention Bundle Reduces Incisional SSI After Colorectal Surgery: Varut Lohsiriwat; Ann Coloproctol. 2021;37(3):146-152. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.04.10.2

10,437 View
299 Download
15 Web of Science
17 Citations

Abstract PDF

Purpose
This study aimed to evaluate association between compliance with surgical site infection (SSI) prevention bundle and the development of superficial or deep incisional SSI following colorectal surgery and to evaluate the impact of incisional SSI on surgical outcomes.
Methods
A prospectively collected database of consecutive patients undergoing elective colectomy and/or proctectomy from 2011 to 2019 in a university hospital was reviewed. The association between compliance with Thailand’s SSI Prevention Bundle (10 level-1A interventions) and the incidence of incisional SSI was determined. Surgical outcomes were compared between those with incisional SSI and those without.
Results
This study included 600 patients with a median age of 64 years (range, 18–102 years). Some 126 patients (21.0%) had stoma formation and 52 (8.7%) underwent laparoscopy. The incidence of incisional SSI was 5.5% (n = 33; 32 superficial incisional SSI and 1 deep incisional SSI). Higher compliance with care bundle tended to decrease incisional SSI (P = 0.20). In multivariate analysis, compliance of 70% or more was the only dependent factor for reducing incisional SSI (odds ratio, 0.39; 95% confidence interval, 0.15 to 0.99; P = 0.047). None of individual interventions were significantly associated with a lower probability of incisional SSI. Compared with counterparts, patients with incisional SSI had a 2-day longer length of postoperative stay (6 day vs. 4 day, P < 0.001) but comparable time for gastrointestinal recovery and similar rate of 30-day mortality or readmission.
Conclusion
High compliance with SSI prevention bundle (especially ≥ 70%) reduced incisional SSI after colorectal surgery.

Citations

Citations to this article as recorded by

PREVENTION OF SURGICAL SITE INFECTIONS: A COMPREHENSIVE REVIEW OF GUIDELINES AND SCIENTIFIC EVIDENCE (2017–2025)
Jakub Tomasz Latos, Katarzyna Anna Kowalska, Franciszek Szweda, Tomasz Poczwardowski, Adrianna Kaczmarek, Marcin Chwalczuk, Olivia Grygorcewicz, Marta Koneczna, Karolina Alicja Krystyniak, Kinga Augustyniak, Klaudia Leszto, Natalia Smuniewska
International Journal of Innovative Technologies in Social Science.2026;[Epub] CrossRef
Colorectal Cancer in China, 1990 to 2023: Trends, Modifiable Risks, and Prevention Priorities Based on Global Burden of Disease 2023 Estimates
Shuai Wang, Jingbo Lv, Li Wang, Hao Wu, Xueyuan Cao
Journal of Gastrointestinal Cancer.2026;[Epub] CrossRef
Guideline-concordant antibiotic prophylaxis on surgical site infection rates following colorectal surgery: real-world data from Thailand
Prapakorn Tanyakul, Varut Lohsiriwat, Pichapat Ngarmskunroongrote, Naddanai Kaewjaidee
Annals of Coloproctology.2026; 42(2): 208. CrossRef
Efectividad de un bundle perioperatorio liderado por enfermería para prevenir la infección del sitio quirúrgico mediante la administración oportuna de antibióticos profilácticos, el control de glucosa y temperatura, y la evitación del rasurado preoperator
Ana Cristina Bautista Sinchico Bautista Sinchico , Karla Nicole Tobar Espinosa , Daniela Anahi Diaz Tamba , Sandra Lorena López Reyes , Jacqueline de los Ángeles Realpe Sandoval
ASCE MAGAZINE.2026; 5(2): 3462. CrossRef
Surgical site infection prevention care bundles in colorectal surgery: a scoping review
T. Cunha, S. Miguel, J. Maciel, C. Zagalo, P. Alves
Journal of Hospital Infection.2025; 155: 221. CrossRef
Empowering patients through a perioperative prevention bundle to reduce surgical site infections in colorectal surgery
Vladimir Nikolic, Ljiljana Markovic-Denic, Stefan Kmezic, Aleksandar Radovanovic, Djordje Nektarijevic, Jelena Djokic-Kovac, Djordje Knezevic, Andrija Antic
American Journal of Infection Control.2025; 53(7): 753. CrossRef
The Impact of Patients’ Engagement in the Prevention of Surgical Site Infections: A Systematic Review
Ashraf A'aqoulah, Munirah Alomran, Nuha Alhumaid, Ashraf El-Metwally, Farah Kalmey
Infection and Drug Resistance.2025; Volume 18: 5761. CrossRef
Systematic review and meta-analysis of outcomes associated with incisional and organ/space surgical site infections in abdominal surgery patients
Shalini Elangovan, Shravya Murali, Amudha Aravindhan, Choon Sheong Seow, Nicholas Graves
Antimicrobial Resistance & Infection Control.2025;[Epub] CrossRef
Surgical Site Infection Prevention Using “Strike Teams”: The Experience of an Academic Colorectal Surgical Department
Buddhi Hatharaliyadda, Michelle Schmitz, Anne Mork, Fauzia Osman, Charles Heise, Nasia Safdar, Aurora Pop-Vicas
Journal for Healthcare Quality.2024; 46(1): 22. CrossRef
Interventions to reduce surgical site infection following elective colorectal surgery: protocol for a systematic review with narrative synthesis and GRADE recommendations
Harry Dean, Ioanna Drami, Amira Shamsiddinova, Eman Alkizwini, James Kinross, Ana Wilson, Phil Tozer, Carolynne Vaizey
Journal of Surgical Protocols and Research Methodologies.2024;[Epub] CrossRef
Effect of a colorectal bundle in an entire healthcare region in Switzerland: results from a prospective cohort study (EvaCol study)
Benjamin Wiesler, Robert Rosenberg, Raffaele Galli, Jürg Metzger, Mathias Worni, Mark Henschel, Mark Hartel, Christian Nebiker, Carsten T. Viehl, Alexandra Müller, Lukas Eisner, Martina Pabst, Urs Zingg, Daniel Stimpfle, Beat P. Müller, Markus von Flüe, R
International Journal of Surgery.2024; 110(12): 7763. CrossRef
Information technologies for supporting prevention, diagnosis and management of surgical site infections in trauma and orthopedic patients
Anton G. Nazarenko, Elena B. Kleimenova, Mikhail A. Dronov, Dmitry S. Gorbatyuk, Nodari M. Kakabadze, Archil V. Tsiskarashvili, Natalia P. Gerasimova, Ekaterina S. Yurchenkova, Liubov P. Yashina
N.N. Priorov Journal of Traumatology and Orthopedics.2024; 31(4): 467. CrossRef
Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons
Jennifer L. Irani, Traci L. Hedrick, Timothy E. Miller, Lawrence Lee, Emily Steinhagen, Benjamin D. Shogan, Joel E. Goldberg, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Diseases of the Colon & Rectum.2023; 66(1): 15. CrossRef
Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and the Society of American Gastrointestinal and Endoscopic Surgeons
Jennifer L. Irani, Traci L. Hedrick, Timothy E. Miller, Lawrence Lee, Emily Steinhagen, Benjamin D. Shogan, Joel E. Goldberg, Daniel L. Feingold, Amy L. Lightner, Ian M. Paquette
Surgical Endoscopy.2023; 37(1): 5. CrossRef
The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Min Ki Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Strategies to Reduce Post-Hemorrhoidectomy Pain: A Systematic Review
Varut Lohsiriwat, Romyen Jitmungngan
Medicina.2022; 58(3): 418. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef

Are There Anorectal Physiologic Factors Prior to Biofeedback Treatment for Constipation that Affect Compliance Rate?.: Shin, Dong Ho , Kim, Seung Cheol , Kim, In Kyoung , Hong, Hyun Ki , Joo, Jae Sik; J Korean Soc Coloproctol. 2006;22(3):162-168.

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Abstract PDF: PURPOSE
The most important factor for the success of biofeedback treatment of constipation is patients' enthusiastic participation and willingness to comply with the treatment protocol. The purpose of this study was to analyze differences among groups of patients classified according to the number of biofeedback sessions and to identify any anorectal physiological and clinical factors related with better compliance with biofeedback treatment.
METHODS
From Aug. 2001 to July 2003, 80 patients who had undergone biofeedback treatment for constipation by a single therapist were classified into three groups according to the number of sessions: only one session (Group I, n=26), two or three sessions (Group II, n=27), and more than four sessions (Group III, n=27). We reviewed the clinical and the anorectal physiological characteristics retrospectively.
RESULTS
The mean age was 39.1 (range, 8~77) years, and the mean duration of constipation was 7.7 (range, 0.5~30) years and mean frequency of defecation was 2.2 times/week. Patients' pretreatment use of laxatives was significantly lower in Group I (38.5 percent) than in Group II (70.4 percent) or Group III (51.9 percent) (P<0.05). There were no significant differences in anal manometric parameters (mean and maximal resting pressure, maximal squeezing pressure, sensitivity, and rectal capacity). In the cinedefecographic findings, the megarectum was significantly higher in Group III (58.3 percent) than in Group I (38.9 percent) or Group II (27.8 percent) (P=0.02), but other findings of anismus, rectocele, intussusception, and delayed emptying showed no significant differences. The cinedefecographic parameters (anorectal angle, perineal descent, anal canal length, and puborectalis length), were not significantiy different among the groups.
CONCLUSIONS
We strongly recommend biofeedback treatment for constipation patients who abuse laxatives and/or for whom cinedefecography reveals megarectum.

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