Environmental impact of the enhanced recovery pathway in colorectal surgery: A simulation study.

Autor: Slim K; Department of Digestive Surgery, Pôle Santé République, ELSAN Group, Clermont-Ferrand, France.; Collectif d'Eco-Responsabilité En Santé, CERES, Beaumont, France., Veziant J; Department of Digestive and Oncological Surgery, University Lille, Claude Huriez University Hospital, Lille, France., Enguix A; Department of Pharmacy, University Hospital CHU Clermont-Ferrand, Clermont-Ferrand, France., Zieleskiewicz L; Department of Anaesthesia, Hôpital Nord, AP-HM, Marseille, France.
Jazyk: angličtina
Zdroj: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2025 Jan; Vol. 27 (1), pp. e17247. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1111/codi.17247
Abstrakt: Aim: Most of the literature on the environmental impact of surgery has analysed operating theatre practice in terms of its contribution to global warming (by greenhouse gas effects). The aim of this study was to assess the overall environmental impact of a complete perioperative pathway with and without implementation of an enhanced recovery programme (ERP).
Method: We compared two scenarios: an ERP scenario and a conventional scenario (CONV) for colorectal surgery. We carried out a lifecycle analysis for perioperative procedures, devices and consumables. We measured the impact on 17 environmental variables in addition to global warming.
Results: The overall environmental impact of ERP was 6% lower than that of conventional care. The reduction of impact due to ERP ranged from 5% for greenhouse gas emissions (18 kg CO 2 equivalent less per intervention) to 27% for water consumption (3 m 3 less). The stages that had the most impact on the environment were the preoperative stage (essentially owing to patient travel) and the intraoperative stage with the surgical part (medical devices representing 83.3% of the impact of the procedure) and the anaesthesia part (halogenated gases and ventilation representing 54.9% of the impact of anaesthesia care).
Conclusion: This study found an ERP approach to be more eco-responsible than conventional care. This is an additional benefit of ERP implementation. The impact of ERP implementation might be further reduced by action on the preoperative and intraoperative stages.
(© 2024 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
Databáze: MEDLINE
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