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Laparoscopic anterior resection for rectosigmoid cancer: Patient outcomes after implementation of a clinical pathway

Authors

  • T.W. Hsu,

    1. Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
    2. Division of General Surgery, Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
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  • F.F. Chiang,

    1. Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
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  • H.M. Wang

    1. Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
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Correspondence
Hwei-Ming Wang, No 160, Sec.3, Taichung Kong Road, Taichung City, Taiwan. Tel: +886 4 23741207
Fax: +886 4 23500920
Email: whm@vghtc.gov.tw

Abstract

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.

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