ln the department concerned, we introduced laparoscopic operations for colon cancer from 1998 and introduced a clinical pathway (CP) into laparoscopic colectomy from 2002. In addition, we performed a revision of CP from April, 2003. This brings us to the present. We investigated variance of CP introduction before and after, and as a result, amended the CP more and inspected the effect of CP introduction.

　Subject and Methods: The subject concerned 76 examples excluding 2 examples among 78 colon cancer cases where this hospital performed laparoscopic colectomy up to December, 2005 from August, 1998.

　Group N were operated on by June, 2001 before (CP introduction, Group P-1 operated on from CP introduction to March, 2003, and Group P-2 operated on until December, 2005 from the CP revision. We divided our study into these three groups and investigated perioperative factors (start of liquid and solid food intake, removal of bladder catheter, getting up, defecation and postoperative hospital stay). The CP schedule was enforced for 10 days from hospitalization 2 days before the operation 2nd to discharge on the 7th postoperative day.

　Results: Except for 9 examples among the 76 examples where a discharge became delayed (we deviate from CP by variance in CP group) by postoperative complications, 67 examples were finally investigated. For the liquid intake start day and the solid food intake start day, significantly early achievement was made in each group by introduction of CP.

　The postoperative hospital stay was shortened significantly by introduction of CP. We decreased variance and CP deviation, with stability of maneuver and innovation of CP.

　Conclusions: As a result of having introduced CP into laparoscopic colectomy, there was a revision of perioperative management methods, and shortening of hospital stays was possible. Furthermore, a decrease of variance was planned, and, by CP revision based on variance analysis after CP induction, standardization of CP was enabled.