Laparoscopic anterior resection for rectosigmoid cancer: Patient outcomes after implementation of a clinical pathway
Article first published online: 27 OCT 2009
© 2010 Asia Endosurgery Task Force and Blackwell Publishing Asia Pty Ltd
Asian Journal of Endoscopic Surgery
Volume 3, Issue 1, pages 18–23, February 2010
How to Cite
Hsu, T.W., Chiang, F.F. and Wang, H.M. (2010), Laparoscopic anterior resection for rectosigmoid cancer: Patient outcomes after implementation of a clinical pathway. Asian Journal of Endoscopic Surgery, 3: 18–23. doi: 10.1111/j.1758-5910.2009.00019.x
- Issue published online: 19 JAN 2010
- Article first published online: 27 OCT 2009
- Received: 7 July 2009; revised 12 August 2009; accepted 26 August 2009
- clinical pathway;
- laparoscopic anterior resection;
- rectosigmoid cancer
Introduction: A clinical pathway designed for a single type of laparoscopic colorectal surgery for cancer might be helpful in decreasing complication rates and total hospital costs. It has been reported to be effective in reducing costs and shortening length of hospital stays in many situations such as laparoscopic cholecystectomy, colon resection, total colectomy, and gastrointestinal bleeding, as well as when caring for patients in the intensive care unit.
Materials and Methods: A clinical pathway, including surgical details and perioperative management, for patients undergoing laparoscopic anterior resection for rectosigmoid cancer was designed and implemented. From January 2003 to December 2006, it was applied to 80 patients.
Results: The average length of a hospital stay for these patients was 9.06 d. The mean hospital stay and total cost decreased year by year. The overall complication rate was 8.75% without perioperative mortality, and 47.5% of patients with underlying diseases were treated safely.
Discussion: Laparoscopic anterior resection for rectosigmoid cancer, with curative or palliative intent, was safe after standardization of surgical details and perioperative management. The total hospital costs for each patient was predictable and decreased year by year.