Background: Recent studies have indicated variations in functional bowel recovery associated with right sided and left-sided colectomies. The current evidence is inadequate to differentiate postoperative enhanced recovery after surgery (ERAS) guidelines based on the side of resection. This study aimed to compare bowel functional recovery between right-sided and left-sided colectomies within a fully implemented ERAS program.
Methods: Patients scheduled for elective colectomies due to benign and malignant conditions were managed according to ERAS protocols and registered into a prospective database between January 2017 and May 2020. The study compared demographic and surgical characteristics, functional recovery, and complications between right-sided and left-sided resections.
Results: This study compared 223 patients who underwent right-sided colectomy with 161 patients who underwent left-sided resections, focusing on baseline demographic and surgical characteristics. Left-sided colectomies exhibited significantly higher BMI, intraoperative blood loss, and duration of surgery. Both groups first experienced Flatus at a median of one postoperative day (p < 0.001). The median time to stool passage was two postoperative days for the right group and one postoperative day for the left group (p < 0.001). Of the patients studied, 37 (17%) developed postoperative ileus (POI) following right-sided colectomy, while 22 (14%) experienced POI after left-sided colectomy (p = 0.5). Compliance with the ERAS protocol was significantly greater in patients undergoing right-sided colectomy (70% right vs. 66% left, p < 0.001).
Conclusion: Right-sided colectomies are associated with slower bowel functional recovery and an increased incidence of POI. However, the cause of this finding remains undetermined and requires further investigation.
Key words: ERAS, colorectal surgery, right hemicolectomy, left hemicolectomy, ERAS compliance, bowel functional recovery, clinical outcome, postoperative ileus, anastomotic leakage.
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