Modified enhanced recovery after surgery protocols significantly accelerated gastrointestinal function recovery, reducing time to first flatus (1.2 vs 2.6 days, p=0.002) compared to traditional care in patients undergoing emergency surgery for obstructive colorectal cancer.
Observational (n=839)
Yes
Does modified ERAS improve gastrointestinal function recovery in patients undergoing emergency surgery for obstructive colorectal cancer?
Modified ERAS protocols are safe and accelerate bowel function recovery, reduce complications, and shorten hospital stay in emergency obstructive colorectal cancer surgery.
Absolute Event Rate: 1.2% vs 2.6%
p-value: p=0.002
Enhanced recovery after surgery (ERAS) is acknowledged to reduce perioperative stress in several surgical diseases. Here, we investigated whether modified ERAS is associated with beneficial effects in the setting of emergency colorectal surgery.We retrospectively evaluated the medical records of 839 consecutive patients with obstructive colorectal cancer undergoing surgical intervention at 4 institutes. Among them, 356 cases were managed with a multidisciplinary team approach to care (modified ERAS protocols), and the remaining 483 cases were treated based on traditional protocols. According to modified ERAS or traditional care, propensity score (PS) matching was performed to adjust biases in patient selection. The primary outcome was gastrointestinal function recovery. Secondary outcomes included postoperative complications and length of hospital stay.Modified ERAS was associated with postoperative gastrointestinal function recovery, including time to first flatus (P = .002), first defecation (P = .008), and prolonged ileus (P = .016). According to the Clavien-Dindo classification, fewer total episodes of grade II or higher postoperative complications were observed in patients cared for with modified ERAS than in patients with traditional care (P = .002). Median (interquartile range) postoperative hospital stay in the modified ERAS group was 6 (3-22) days versus 9 (7-27) days in the traditional care group (P < .001). Furthermore, the interval from operation to postoperative chemotherapy (d) was significantly shorter in the modified ERAS group (35.6 ± 11.5 vs 47.6 ± 23.8, P < .001).The modified ERAS was safe and associated with clinical benefits, including fast recovery of bowel function, reduced postoperative complications, and shorter hospital stay for patients with obstructive colorectal cancer.
Shang et al. (Sat,) conducted a observational in Obstructive colorectal cancer (n=839). Modified enhanced recovery after surgery (ERAS) protocols vs. Traditional care protocols was evaluated on Time to first flatus (days) (p=0.002). Modified enhanced recovery after surgery protocols significantly accelerated gastrointestinal function recovery, reducing time to first flatus (1.2 vs 2.6 days, p=0.002) compared to traditional care in patients undergoing emergency surgery for obstructive colorectal cancer.