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Small steps lead to a faster recovery for colorectal surgery patients

Toronto, March 3, 2014

By Bao Xiong

Patricia Daniels
Nurse Lindsay Watson assists colorectal surgery patient Heather Bellmore to get moving soon after her operation. (Photo by Katie Cooper)


Did you know?

There are approximately 14,000 colon resections performed in Ontario each year, with an average hospital stay of seven days.


With any major surgery comes plenty of bed rest and recuperation. But since October 2012, 165 patients undergoing colorectal surgery at St. Michael’s have experienced fewer postoperative complications, a faster recovery and earlier discharge, thanks to ERAS—the Enhanced Recovery After Surgery program.

One of the program’s main objectives is early mobilization, meaning patients are encouraged to start walking as soon as the day after they have surgery.

“Prior to ERAS, our average length of stay for anybody having colorectal surgery was about eight days—now the average is six,” said Joan Park, a case manager on 16 Cardinal Carter North. “What excites us is the people who are leaving on day three and day four, and what surprises us is that a lot of the people going home earlier are 80 years old.”

On the night of their surgery, patients are expected to sit on the side of their bed and dangle their legs. If strong enough, some are even able to stand up. The next day they are encouraged to walk to the bathroom or in the hallway with the help of a nurse.

Walking is the biggest component of ERAS, but the program also emphasizes the importance of early feeding and good pain management. Patients are also instructed on what procedures will follow surgery—meaning they are more inclined to perform minimal exercises after understanding its benefits.

Meanwhile, the walls of 16 Cardinal Carter North have become a helpful pedometer for the patients. Every 10 feet is marked with a blue footprint sticker measuring the distance as they walk. Completing a full lap around the floor evens out to an exact 100 metres, and walking 10 laps around 16 Cardinal Carter North is the equivalent of one full kilometre.

But the greatest encouragement for the patients is the support of the nursing staff that never fails to cheer them on.

“We’re all thrilled when we see them making their way down the hall,” said Park. “In the end, we see them going home sooner and stronger.”

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.