Enhanced Recovery After Colorectal Surgery

Historically there have been countless paths to recovery following colorectal surgery. However, having a well-rounded, evidence-based enhanced recovery program is critical to patient success. Two Vizient experts, Mark Ninno and Karen Smethers discuss the details and the power of these programs.


 Guest speakers:

Mark Ninno, PharmD

Senior Consulting Solutions Director



Karen Smethers, PharmD, BCOP

MSS Pharmacy Network

Senior Director

Vizient Pharmacy Member Services



Gretchen Brummel, PharmD, BCPS

Pharmacy Executive Director

Vizient Center for Pharmacy Practice Excellence


Show Notes:

[01:21] Enhanced recovery programs are specific programs designed to help patients after surgery

[01:59] Strong recovery programs involve four pillars to achieve its goal of patient discharge: patient-centered, multi-modal, multidisciplinary and evidence-based approaches

[03:29] Vizient observes that health systems have a wide variety of practices following colorectal surgery

[03:56] Vizient gathered a panel of experts to assess and evaluate recovery programs

[04:16] The expert panel focused on two specific domains: literature review and expert opinion    

[05:33] Vizient evidence review includes pharmacological and non-pharmacological interventions

[06:09] Early introduction of oral feeding proved to have the strongest support in recovery

[06:24] Studies involving alvimopan contain many factors that hinders its application in an enhanced recovery program

[07:10] Vizient found many systems are supporting alvimopan use in minimally invasive surgery even though the evidence may not fully support this practice

[07:46] Non-drug regiments such as chewing gum and caffeine have been handed down for many years, yet these therapies have minimal benefits

[08:33] It’s critical for front line pharmacists to collaborate with all health care professionals

[08:59] Education of prescribers, patients and family members provide many benefits


Links | Resources:

American Association of Nurse Anesthesiology (AANA): Enhanced Recovery after Surgery Click here

Scott MJ, Baldini G, Fearon KCH, et al. Enhanced Recovery After Surgery (ERAS®) for gastrointestinal surgery, part 1: pathophysiological considerations. Act Anaesthesiol Scand. 201559(10):1212-1231 Click here

Gustafsson UO, Scott MJ, Hubner M, Et al, Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World J Surg. 2019 ;43(3):659-695 Click here


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