Enhanced recovery after surgery, based perioperative bundle reduces 30-day unplanned readmission after laparoscopic colorectal cancer surgery

Table 1 Comparison of general information between two groups, n (%)/mean ± SD

Item	Control group (n = 38)	Intervention group (n = 39)	Test statistic	P value
Age (years)	62.4 ± 11.8	61.7 ± 12.3	t = 0.257	0.798
Gender			χ² = 0.041	0.84
Male	22 (57.9)	23 (59.0)
Female	16 (42.1)	16 (41.0)
BMI (kg/m2)	23.1 ± 3.2	22.8 ± 3.4	t = 0.403	0.688
Smoking history	14 (36.8)	13 (33.3)	χ² = 0.102	0.749
Drinking history	11 (28.9)	12 (30.8)	χ² = 0.032	0.858
Tumor location			χ² = 0.267	0.875
Colon cancer	23 (60.5)	25 (64.1)
Rectal cancer	15 (39.5)	14 (35.9)
TNM staging			χ² = 1.247	0.536
Stage I	8 (21.1)	6 (15.4)
Stage II	17 (44.7)	20 (51.3)
Stage III	13 (34.2)	13 (33.3)
Preoperative CEA (ng/mL)	8.7 ± 12.4	9.2 ± 13.1	t = -0.173	0.863
Comorbidities
Hypertension	15 (39.5)	16 (41.0)	χ² = 0.019	0.89
Diabetes	9 (23.7)	8 (20.5)	χ² = 0.116	0.733
Coronary heart disease	5 (13.2)	4 (10.3)	χ² = 0.158	0.691
ASA classification			χ² = 0.412	0.814
Grade I	12 (31.6)	14 (35.9)
Grade II	21 (55.3)	20 (51.3)
Grade III	5 (13.2)	5 (12.8)

ASA: American Society of Anesthesiologists; CEA: Carcinoembryonic antigen; BMI: Body mass index.

Table 2 Comparison of 30-day unplanned readmission between two groups, n (%)

Readmission cause	Control group (n = 38)	Intervention group (n = 39)	Statistical method	P value
Incision infection	4 (10.5)	1 (2.6)
Anastomotic leakage	2 (5.3)	0 (0)
Intestinal obstruction	1 (2.6)	1 (2.6)
Intra-abdominal infection	1(2.6)	0 (0)
Bleeding	1(2.6)	0 (0)
Total	9 (23.7)	2(5.1)	Fisher’s exact test	0.024

Table 3 Comparison of recovery-related indicators between two groups, mean ± SD

Indicator	Control group (n = 38)	Intervention group (n = 39)	Test statistic	P value
Time to first ambulation (hours)	36.8 ± 8.4	18.6 ± 4.2	t = 11.529	< 0.001
Time to first flatus (hours)	58.7 ± 16.3	42.1 ± 12.8	t = 4.886	< 0.001
Time to first defecation (days)	4.2 ± 1.1	3.1 ± 0.8	t = 4.949	< 0.001
Gastrointestinal function recovery time (days)	5.8 ± 1.4	4.2 ± 1.2	t = 5.350	< 0.001

Table 4 Comparison of postoperative pain scores between two groups (Numerical Rating Scale scores), mean ± SD

Time point	Control group (n = 38)	Intervention group (n = 39)	t value	P value
Postoperative day 1	4.2 ± 1.2	3.1 ± 0.9	4.573	< 0.001
Postoperative day 3	3.1 ± 1.0	2.3 ± 0.8	3.842	< 0.001
Postoperative day 7	2.2 ± 0.8	1.5 ± 0.6	4.327	< 0.001

Table 5 Comparison of Barthel Index Scores between two groups (points), mean ± SD

Time point	Control group (n = 38)	Intervention group (n = 39)	t value	P value
Preoperative	95.8 ± 6.2	96.4 ± 5.8	-0.444	0.659
At discharge	85.2 ± 6.8	90.1 ± 5.9	-3.418	0.001
30 days postoperatively	92.1 ± 6.2	95.8 ± 4.7	-2.967	0.004

Table 6 Comparison of 36-item short-form health survey quality of life scores between two groups (points), mean ± SD

Dimension	Time point	Control group (n = 38)	Intervention group (n = 39)	t value	P value
Physical functioning	Preoperative	82.4 ± 12.6	83.7 ± 11.8	-0.467	0.642
	30 days postoperatively	71.2 ± 13.8	78.6 ± 12.4	-2.473	0.015
Role-physical	Preoperative	76.3 ± 18.4	78.2 ± 16.7	-0.474	0.637
	30 days postoperatively	63.8 ± 16.8	72.4 ± 15.2	-2.353	0.021
Bodily pain	Preoperative	81.5 ± 14.2	82.8 ± 13.6	-0.41	0.683
	30 days postoperatively	72.4 ± 14.2	79.1 ± 12.8	-2.173	0.033
General health	Preoperative	71.6 ± 16.3	73.4 ± 15.8	-0.492	0.624
	30 days postoperatively	64.1 ± 16.2	72.3 ± 14.6	-2.331	0.022
Vitality	Preoperative	69.8 ± 17.2	71.3 ± 16.4	-0.391	0.697
	30 days postoperatively	60.4 ± 17.4	69.2 ± 15.8	-2.322	0.023
Social functioning	Preoperative	78.9 ± 15.6	80.1 ± 14.3	-0.352	0.726
	30 days postoperatively	69.2 ± 16.1	76.8 ± 14.7	-2.162	0.034
Role-emotional	Preoperative	73.2 ± 19.8	75.4 ± 18.2	-0.507	0.613
	30 days postoperatively	62.8 ± 18.9	71.6 ± 16.4	-2.18	0.032
Mental health	Preoperative	72.4 ± 16.7	74.1 ± 15.3	-0.465	0.643
	30 days postoperatively	66.2 ± 16.4	73.8 ± 14.8	-2.134	0.036