Title

Enhanced Recovery After Colon and Rectal Surgery

Authoring Organizations

Publication Month/Year

August 1, 2017

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Inclusion Criteria

Female, Male, Adolescent, Adult, Older adult

Health Care Settings

Emergency care, Hospital, Operating and recovery room

Intended Users

Medical assistant, nurse, nurse practitioner, physician, physician assistant

Scope

Management, Treatment

Diseases/Conditions (MeSH)

D003107 - Colorectal Surgery

Keywords

Colon and Rectal Surgery, enhanced recovery, colectomy, Proctectomy

Source Citation

Carmichael, Joseph C. M.D.1; Keller, Deborah S. M.S., M.D.2; Baldini, Gabriele M.D.3; Bordeianou, Liliana M.D.4; Weiss, Eric M.D.5; Lee, Lawrence M.D., Ph.D.6; Boutros, Marylise M.D.6; McClane, James M.D.7; Feldman, Liane S. M.D.6; Steele, Scott R. M.D.8 Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons, Diseases of the Colon & Rectum: August 2017 - Volume 60 - Issue 8 - p 761-784 doi: 10.1097/DCR.0000000000000883
 

Supplemental Methodology Resources

Data Supplement

Methodology

Number of Source Documents
371
Literature Search Start Date
January 1, 1990
Literature Search End Date
December 31, 2016
Description of External Review Process
Final recommendations were approved by each society’s committee and executive council.
Specialties Involved
Colon And Rectal Surgery, Emergency Medicine, Family Medicine, Gastroenterology, Internal Medicine General
Description of Systematic Review
Yes.The details of specific search strategies, including search terms, inclusion criteria, exclusion criteria, total number of studies identified, and tables of evidence for each statement, are available in the supplements, but all of the search strategies involved an organized search of MEDLINE, PubMed, EMBASE and the Cochrane Database of Collected Reviews using a variety of key word combinations.
List of Questions
Refer to full text.
Description of Study Criteria
Refer to "Supplementary Document 1 – Detailed Summary of Search Strategies."
Description of Search Strategy
Refer to "Supplementary Document 1 – Detailed Summary of Search Strategies." Systematic searches were conducted from 1990 to 2016 and were restricted to English-language articles. Directed searches of the embedded references from the primary articles were also performed in certain circumstances.
Description of Study Selection
Refer to "Supplementary Document 1 – Detailed Summary of Search Strategies."
Description of Evidence Analysis Methods
Refer to "Supplementary Document 1 – Detailed Summary of Search Strategies."
Description of Evidence Grading
Refer to "Supplementary Document 1 – Detailed Summary of Search Strategies."
Description of Recommendation Grading
The ACCP system for grading guideline recommendations is based on the relationship between the strength of evidence and the balance of benefits to risk and burden (Table 3 of the original guideline document). Simply stated, recommendations can be strong (grade 1) or weak (grade 2). If there is certainty that the benefits do (or do not) outweigh risk, the recommendation is strong. If there is less certainty or the benefits and risks are more equally balanced, the recommendation is weaker. Several important issues must be considered when classifying recommendations. These include the quality of the evidence that supports estimates of benefit, risks, and costs; the importance of the outcomes of the intervention; the magnitude and precision of the estimate of treatment effect; the risks and burdens of an intended therapy; the risk of the target event; and varying patient values. The benefit-to-harm ratio includes consideration of the clinical improvements in health and quality of life as well as the burdens, risks, and costs, when applicable, identifiable, and determinable (Table 1). Patient and community values are important considerations in clinical decision-making and are factored into the grading process. In situations where the benefits clearly do or do not outweigh the risks, it is assumed that nearly all patients would have the same preferences. For weaker recommendations, however, there may not be consistency in patient preferences.
Description of Funding Source
ASCRS and SAGES funded the Guideline Development.
Company/Author Disclosures
The Authors list their disclosures in the publication.
Percentage of Authors Reporting COI
100