Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries

doi:10.1136/bmj.38478.568067.AE

BMJ 2005;330:1420-1421 (18 June), doi:10.1136/bmj.38478.568067.AE (published 23 May 2005)

Paper

Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries

Kristoffer Lassen, consultant surgeon¹, Pascal Hannemann, surgical registrar², Olle Ljungqvist, professor of surgery³, Ken Fearon, professor of surgery⁴, Cornelis H C Dejong, consultant surgeon², Maarten F von Meyenfeldt, professor of surgery², Jonatan Hausel, doctoral student³, Jonas Nygren, associate professor of surgery³, Jens Andersen, consultant surgeon⁵, Arthur Revhaug, professor of surgery¹, on behalf of the Enhanced Recovery After Surgery (ERAS) Group

¹ Department of Gastrointestinal Surgery, University Hospital of Northern Norway, 9038 Tromsø, Norway, ² Department of Surgery, University Hospital Maastricht, Maastricht 6202 AZ, Netherlands, ³ Centre for Surgical Sciences, Division of Surgery, Karolinska University Hospital, Stockholm, Sweden, ⁴ Clinical and Surgical Sciences (Surgery), School of Clinical Sciences and Community Health, University of Edinburgh, Edinburgh EH16 4SA, ⁵ Department of Surgical Gastroenterology, 435 Hvidovre University Hospital, Hvidovre 2650, Denmark

Correspondence to: K Lassen lassen@unn.no

The first 150 words of the full text of this article appear below.

Introduction

Evidence for optimal perioperative care in colorectal surgeryis abundant. By avoiding fasting, intravenous fluid overload,and activation of the neuroendocrine stress response, postoperativecatabolism is reduced and recovery enhanced. The specific measuresthat can be used routinely include no bowel preparation, epiduralanaesthesia/analgesia continued for one to two days postoperatively,no nasogastric decompression tube postoperatively, intravenousfluid/saline restriction, and free oral intake from postoperativeday one.^1-5 This survey aimed to characterise perioperativepractice in colorectal cancer surgery in five northern Europeancountries: Scotland, the Netherlands, Denmark, Sweden, and Norway.

Participants, methods, and results

We mailed a questionnaire to the head surgeons of all digestivesurgical centres in the five countries of the departments belongingto the Enhanced Recovery After Surgery (ERAS) Group in latespring 2003. We presented a hypothetical case of elective laparotomywith colonic resection for cancer in an otherwise healthy 70year old man. We asked the respondents to answer . . . [Full text of this article]

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This article has been cited by other articles:

Lassen, K., Soop, M., Nygren, J., Cox, P. B. W., Hendry, P. O., Spies, C., von Meyenfeldt, M. F., Fearon, K. C. H., Revhaug, A., Norderval, S., Ljungqvist, O., Lobo, D. N., Dejong, C. H. C., for the Enhanced Recovery After Surgery (ERAS) Gro, (2009). Consensus Review of Optimal Perioperative Care in Colorectal Surgery: Enhanced Recovery After Surgery (ERAS) Group Recommendations. Arch Surg 144: 961-969 [Abstract] [Full text]
Urbach, D. R, Baxter, N. N (2005). Reducing variation in surgical care. BMJ 330: 1401-1402 [Full text]

Rapid Responses:

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use of epidurals for colorectal surgery: julian m brown
bmj.com, 21 Jun 2005 [Full text]
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