Risk management model of the early recovery program of the elective colorectal surgery

Abstract

Introduction: Perioperative risk management supported by programs or protocols for early or improved recovery after surgery validates the quality of perioperative care, with a decrease in the incidence of morbidity and mortality based on the evidence of a set of actions covering the entire perioperative period.

Objective: To validate the program for early recovery after colorectal surgery in elective surgical patients at María Curie Provincial Teaching Oncological Hospital and Manuel Ascunce Domenech University Hospital, both in Camagüey Province, as well as at Carlos Manuel de Céspedes General University Hospital in Granma Province.

Methods: The research was carried out in two phases. In phase I, external and internal validation of the early recovery program for elective colorectal surgery was carried out by means of expert consultation using a Likert scale. In phase II, an experimental pilot study was carried out with two groups of 119 patients each.

Results: Most of the patients in the study group (97.5 %) had optimal early recovery, based on the fact that they did not present pain, paralytic ileus, either cardiovascular or respiratory complications perioperatively. 94.1 % of the patients in the study group were discharged in the condition of living, with an average hospital stay of five days, lower than the nine days of the control group.

Conclusions: The early recovery program shows a decrease in the incidence of morbidity and mortality, as well as a reduction in hospital stay, with benefits for both the patient and the health services.

Keywords: anesthesia; evidence-based medicine; neoplasia; colorectal neoplasia; colorectal surgery.