Effect of a clinical pathway after laparoscopic surgery for colorectal cancer

BACKGROUND/AIMS: The purpose of this study was to evaluate whether implementation of a clinical pathway (CP) reduces length of stay after laparoscopic surgery for colorectal carcinoma. METHODOLOGY: We retrospectively reviewed 330 patients with colorectal carcinoma who underwent laparoscopic surgery between 2002 and 2006. The patients were divided into 2 groups: no clinical pathway patients in 2002-03 (Group A) and those managed with clinical pathway in 2004-06 (Group B). Patients in Group B were planned to be discharged and return home within postoperative day 8, with use of CP. RESULTS: There was no mortality in either group. In Group B, the rate of patients who started solid food within postoperative day 3 was significantly higher than in Group A for both colon carcinoma (96.7 vs. 82.8%, p = 0.001) and rectal carcinoma (94.2 vs. 65.5%, p = 0.001). The rate of patients discharged within postoperative day 8 was significantly higher in Group B than in Group A (98.5 vs. 64.8%, p = 0.001), although there were more advanced cases in Group B. CONCLUSIONS: The implementation of clinical pathway has led to the standardization of patient care and considerable decrease in length of stay after laparoscopic surgery for colorectal carcinoma.