Abstract：
:Introduction Short hospital stays and accelerated discharge within 72 hours following colorectal cancer resections have not been widely achieved. Series reporting on accelerated discharge involve heterogeneous patient populations and exclude important groups. Strict adherence to some discharge requirements may lead to delays in discharge. The aim of this study was to evaluate the safety and feasibility of accelerated discharge within 72 hours of all elective colorectal cancer resections using simple discharge criteria. Methods Elective colorectal cancer resections performed between August 2009 and December 2015 by a single surgeon were reviewed. Perioperative care was based on an enhanced recovery programme. A set of simplified discharge criteria were used. Outcomes including postoperative complications, readmissions and reoperations were compared between patients discharged within 72 hours and those with a longer postoperative stay. Results Overall, 256 colorectal cancer resections (90% laparoscopic) were performed. The mean patient age was 70.8 years. The median length of stay was 3 days. Fifty-eight per cent of all patients and sixty-three per cent of patients undergoing laparoscopic surgery were discharged within 72 hours. Accelerated discharge was not associated with adverse outcomes compared with delayed discharge. Patients discharged within 72 hours had significantly fewer postoperative complications, readmissions and reoperations. Open surgery and stoma formation were associated with discharge after 72 hours but not age, co-morbidities, neoadjuvant chemoradiation or surgical procedure. Conclusions Accelerated discharge within 72 hours of elective colorectal resection for cancer is safely achievable for the majority of patients without compromising short-term outcomes.
journal_name
Ann R Coll Surg Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Emmanuel A,Chohda E,Botfield C,Ellul Jdoi
10.1308/rcsann.2017.0149subject
Has Abstractpub_date
2018-01-01 00:00:00pages
52-56issue
1eissn
0035-8843issn
1478-7083journal_volume
100pub_type
杂志文章abstract：INTRODUCTION:Modernisation of Medical Careers dictates a shortening of the training required to achieve consultant status. Precisely what type of work these consultants could be expected to accomplish, and be trained to do, is not clear. The objective of this study was to demonstrate a method of stratifying urological ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/1478708051748
更新日期：2005-09-01 00:00:00
abstract：:A computerised audit system was used to monitor clinical and administrative management of surgical patients in a District General Hospital. In one year (1985) there were 1,060 discharges from 27 beds (39.3 patients/bed/year). Operative treatment was required in 652 patients but 408 patients did not undergo surgery. Of...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：:Primary hyperparathyroidism may be cured surgically by complete excision of abnormal parathyroid tissue. Reoperation for persistent hypercalcaemia due to residual abnormal parathyroid tissue may be associated with a high complication rate. It is possible to assay intact parathormone (iPTH) intraoperatively and as iPTH...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:Endoscopic papillotomy without cholecystectomy has been performed in 20 elderly patients with complications of bile duct stones. Good biliary drainage was achieved in 17, and there were no complications. One cholecystectomy was subsequently required. Later deaths have been due to unrelated causes. It is concluded that...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:A new process has been used to develop Biogel Super-Sensitive gloves which are thinner but theoretically as strong as standard Biogel gloves. The two types of glove were compared for their effects on manual sensitivity and dexterity in a randomised controlled trial. The Super-Sensitive gloves impaired sensitivity sign...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1996-05-01 00:00:00
abstract：:The management and follow up of 200 consecutive patients with renal and ureteric calculi are presented. The primary treatment of 185 (92.5%) was by extracorporeal shockwave lithotripsy (ESWL), of whom three (1.6)%) with large calculi underwent percutaneous nephrolithotripsy (PCNL) prior to ESWL as a planned combined p...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1985-11-01 00:00:00
abstract：:From the experience of treating 91 patients with a proven recurrent ulcer we consider that if a proven ulcer is shown to be present and a gastrin-secreting tumour is excluded an appropriate reoperation will almost always produce a successful result (94 per cent). Before subjecting patients to reoperation all attempts ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：:The introduction of modern business management practices in the National Health Service has exposed different levels of management training and expertise between clinicians and hospital managers. This is undesirable and frequently unproductive. This article puts the case for the inclusion of business management traini...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1997-09-01 00:00:00
abstract：INTRODUCTION:There has been regular dialogue regarding the importance of developing clinical networks to compensate for the steady decline in general paediatric surgery performed by adult surgeons. Despite this dialogue, there are no contemporary published data to quantify the issue. This report documents patterns in d...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2019.0178
更新日期：2020-04-01 00:00:00
abstract：:Intra-operative injury to the ureter is a well known but fortunately uncommon complication of any major pelvic surgical procedure. If recognised on table, it can be repaired by either a substitution ureteroplasty or end-to-end anatomical repair depending upon the extent of tissue loss. Either of these anastomoses coul...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
abstract：:We describe a rare case of a leiomyosarcoma in the inguinal canal in a patient presenting clinically with an inguinal hernia. The clinical details, histological findings and surgical management are reviewed. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X13946184902208
更新日期：2014-09-01 00:00:00
abstract：:In the Royal Navy, after surgery, the time that servicemen spend away from work and the level of duty to which they return are decisions made by the surgeon, not the general practitioner. In a prospective study, we have thus been able to assess the acceptability of return to full duty at decreasing intervals after hig...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1989-11-01 00:00:00
abstract：INTRODUCTION:Insulinoma is a rare, but curable, endocrine tumour. The ability to localise the tumour accurately before or during surgery is an important factor in the management of these elusive lesions, which has been extensively debated. We have reviewed our experience of these lesions to establish the role of locali...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588407X179008
更新日期：2007-04-01 00:00:00
abstract：:Giant central lumbar disc protrusions can pose a significant operative challenge. Clinically, these patients are at risk of permanent disability, due not only to preoperative neural compromise caused by the protrusion itself but also to the potential iatrogenic risks associated with the standard extradural microdiscec...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0218
更新日期：2018-03-01 00:00:00
abstract：:Introduction There is a known correlation between anaerobic threshold (AT) during cardiopulmonary exercise testing and development of cardiopulmonary complications in high-risk patients undergoing oesophagogastric cancer surgery. This study aimed to assess the value of routine retesting following neoadjuvant chemother...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2018.0067
更新日期：2018-09-01 00:00:00
abstract：:A 1-year prospective study of all surgical activity was undertaken by the Orthopaedic Unit using two weighting systems for operative complexity: the Intermediate Equivalent (IE) and the Operative Complexity Score (OCS). The objectives were to define the difference between caseload and workload, and to formulate a reas...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1993-09-01 00:00:00
abstract：INTRODUCTION:The aim of this study was to investigate the degree of contamination of a surgeon's hand following use of chlorhexidine gluconate or alcohol gel as disinfectants. MATERIALS AND METHODS:In this prospective, randomised trial, orthopaedic surgeons were allocated to one of two different hand-washing protocols...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,随机对照试验
doi：10.1308/003588406X83032
更新日期：2006-01-01 00:00:00
abstract：:Scintigraphy was performed on 180 patients with suspected biliary tract disease using technetium-99m-labelled derivatives of iminodiacetic acid. Most of the patients were also evaluated by conventional techniques and the results were correlated with the findings at operation and with histological examination of tissue...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1981-09-01 00:00:00
abstract：:A randomized controlled trial has been conducted into the effects of discharging patients from hospital either at 48 h or 6-7 days after operation for inguinal hernia or varicose veins. There was no statistically significant difference in the frequency of major postoperative complications between the two lengths of st...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1977-05-01 00:00:00
abstract：:We present a case of distal venous embolisation of a peripheral intravenous cannula tip that had lost its structural integrity through repeated failed attempts of insertion of the same cannula, contrary to protocols for intravenous access. Radiological imaging confirmed the presence of a foreign body in the middle fin...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588413X13629960047830
更新日期：2013-10-01 00:00:00
abstract：:Little is known about the outcome after pancreatic debridement in the district general hospital (DGH) setting and the debate about centralisation of pancreatic surgical services continues. We retrospectively reviewed our experience over 2 years, looking particularly at mortality, morbidity and cost. Of 12 cases treate...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章,评审
doi：10.1308/003588402760452394
更新日期：2002-09-01 00:00:00
abstract：:The nature of inhaled foreign bodies in the respiratory tract and problems in their removal are reviewed with reference to experience in a series of 41 cases, 36 of them in children under 4 years old. Bronchoscopic removal under general anaesthesia is preferred to inhalational therapy and postural drainage. ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1981-03-01 00:00:00
abstract：:Luc's abscess is a rare but important complication of acute otitis media (AOM), whereby infection spreads from the middle ear, resulting in a subperiosteal collection beneath the temporal muscle. Unlike other extracranial abscesses relating to AOM, Luc's abscess is not believed to involve the mastoid bone. We present ...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588414X13946184901281
更新日期：2014-07-01 00:00:00
abstract：:A term neonate was born with a grossly swollen and discoloured left hand and forearm. He was transferred from the local hospital to the plastic surgical unit, where a diagnosis of compartment syndrome was made and he underwent emergency forearm fasciotomies at six hours of age. Following serial debridements of necroti...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2016.0159
更新日期：2016-09-01 00:00:00
abstract：:Using ward rounds in the department of surgery at a major teaching hospital, and with the help of the preregistration house officers (PRHO), we assessed whether the lesson taught to us by Semmelweis had been forgotten. We asked the PHROs to count the number of patients examined by their consultant or registrar on a wa...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1999-03-01 00:00:00
abstract：:The successful treatment of major burns depends upon accurate and early fluid replacement in the first 36 h. A burns calculator has been designed, based upon the Muir and Barclay formula, which should facilitate the estimation of fluid requirements in burned patients and therefore improve their immediate management in...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1982-09-01 00:00:00
abstract：INTRODUCTION:Although examination under anaesthesia and panendoscopy (EUAP) has traditionally been used in the assessment of patients presenting with oral cavity and oropharyngeal squamous cell carcinoma (SCC), the era of modern medicine with its advanced imaging techniques has meant that the indications for this techn...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588409X432446
更新日期：2009-10-01 00:00:00
abstract：:Malignant peripheral nerve sheath tumours (MPNSTs) are a rare but aggressive form of soft tissue sarcoma with few reported cases in the anatomic location seen with the case presented here. This case involves a 23-year-old man presenting with a soft tissue mass under the mandible found to be a MPNST, which was investig...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/rcsann.2017.0060
更新日期：2017-05-01 00:00:00
abstract：:The addition of pressure and flow rate recordings to conventional cystourethrography is relatively inexpensive in terms of cost and of radiologist's time, each investigation requiring approximately half an hour.The value of this investigation in males lies in assessing the severity and site of outlet obstruction, part...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：
更新日期：1974-08-01 00:00:00
abstract：:INTRODUCTIONAbstracts presented at national and international scientific meetings are an important educational resource. However, the work is not peer reviewed and little is known about the quality or validity of the presented results and the fate of such abstracts.MATERIALS AND METHODSThis is a retrospective cohort s...
journal_title：Annals of the Royal College of Surgeons of England
pub_type： 杂志文章
doi：10.1308/003588406X82961
更新日期：2006-01-01 00:00:00
