Enhanced Recovery Programme
Enhanced recovery is a way in which we care for our patients
before, during and after an operation. There is strong evidence
that this will enable you to recover faster from your operation,
with fewer complications. This will mean you can go home and
return to normal function sooner.
This section of our website provides you with information about
what is involved in the enhanced recovery programme. You will also
be given a diary that has been designed so that you know what to
expect and can plan your recovery on the ward following your
operation. This is also available on the website here
(HYPERLINK).
The programme involves all the staff caring for you
(anaesthetists, nurses, dieticians, physiotherapists and surgeons)
helping you to follow a clearly defined programme. Most
importantly, it requires your active participation to make it work.
It is therefore really important that you have a good idea what to
expect and that you understand that the majority of patients can
follow the program. It may be hard work, but with help you can meet
the targets, and by doing so you will make sure that you get over
the operation quicker.
The program is split into different phases before, during and
after the operation itself. This aims to make sure that:
- You are in the best possible condition for surgery;
- Your operation and anaesthetic are performed to help you
recover more quickly afterwards;
- You have the best post-operative rehabilitation to
minimise your risk of problems.
Before the operation
It is really important that you do everything you can to get
yourself in the best possible condition for major surgery. This
includes:
- Stopping smoking;
- Carefully managing your weight;
- Carefully managing other conditions such as diabetes.
One of the most common problems our patients encounter after
surgery is having a chest infection. Sometimes this can be severe,
and at times it may be life-threatening. Stopping smoking will make
a big difference to help reduce your risk of having a bad chest
infection after your operation. The surgical team or your GP can
help you obtain support doing this, such as nicotine replacement
patches or support groups.
Although many of our patients have difficulty eating and
drinking, a lot of people having surgery remain overweight or
obese. It is important to have a balanced diet that contains all
the nutrition required to ensure you are healthy for your
operation. However, if you are overweight, it is also very
important to carefully manage your diet and exercise to lose weight
in a controlled way. Like being a smoker, being overweight or obese
increases the risk of having a bad chest infection after your
operation, makes the operation more difficult, and increases the
risk of other problems that can occur such as wound infections.
Your team can help support and advise you how to achieve controlled
weight loss, and can refer you to a dietitian if this is
needed.
During the operation
Your team of surgeons and anaesthetists will do their best to
perform your operation in a way that allows you to recover as
quickly and smoothly as possible. For example, we routinely
use keyhole surgery to reduce pain, although this is not always
possible or appropriate for all patients.
After the operation
During your stay after your surgery, you will have goals to
achieve each day. For example, this will tell you what you should
be drinking and/or eating, and how much you should be moving about
and getting out of bed. Detailed information is provided in your
diary. For example, on the first day after having an
oesophagectomy, you will walk 30 metres or march 30 steps stood on
the spot twice. You will also sit out of the bed for two hours
twice. Knowing what to expect and what is normal during your
recovery will help you achieve these goals, improving your
recovery, and reducing your chance of having problems or
complications.