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Original Research Article|Articles in Press

Day-case loop ileostomy reversal based on the community hospital joined enhanced recovery after surgery (CHJ-ERAS) program in China: Safe and feasible

  • Author Footnotes
    1 These authors contributed equally to this work.
    Yu Shen
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Mingtian Wei
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
    Ting-Han Yang
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Ye Shu
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Lin Xia
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Qingbin Wu
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Hao Huang
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Xiangbing Deng
    Correspondence
    Corresponding author.
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Wenjian Meng
    Correspondence
    Corresponding author.
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Zi-Qiang Wang
    Correspondence
    Corresponding author.
    Affiliations
    Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang Street, Chengdu, Sichuan Province, China
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  • Author Footnotes
    1 These authors contributed equally to this work.
Published:January 31, 2023DOI:https://doi.org/10.1016/j.amjsurg.2023.01.027

      Highlights

      • The CHJ-ERAS program for DLIR has been proved safe and feasible, with over 90% of patients recovering with uncomplicated recovery.
      • This is the first study reporting the application of the DLIR process in developing countries with the largest samples of patients in a single center.
      • The current study provides a new and feasible form of enhanced recovery after surgery (ERAS) in developing countries.

      Abstract

      Background

      This study was performed to determine the feasibility of Day-case loop ileostomy reversal (DLIR) in China based on the community hospital joined enhanced recovery after surgery (CHJ-ERAS) program.

      Method

      Patients who underwent loop ileostomy were enrolled in the CHJ-ERAS program for DLIR after rigorous evaluation. The primary outcome was the results of short-term follow-ups.

      Results

      From August 2017 to April 2022, 216 patients have been enrolled in the CHJ-ERAS program for DLIR. After DLIR, 14 patients (14/216, 6.5%) have recorded 17 episodes of postoperative complications within 1 month after surgery, including 10 readmission and 2 reoperation. Compared with in-patient loop ileostomy reversal, DLIR based on CHJ-ERAS did not increase the postoperative complications and reoperations.

      Conclusion

      The CMJ-ERAS program for DLIR in our center is a safe and feasible alternative option for inpatient LIR and an acceptable transitional approach for the development of day-case DLIR in developing countries.

      Keywords

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