Key result
Enhanced recovery after surgery (ERAS) was independently associated with a reduced risk of postoperative overall complications in colorectal cancer patients (OR 0.440; 95% CI 0.295-0.656; P<0.01).
Why the study?
It was unclear whether enhanced recovery after surgery (ERAS) could effectively improve prognosis and reduce hospitalization expenses for colorectal cancer patients during the COVID-19 pandemic.
Does enhanced recovery after surgery (ERAS) improve short-term outcomes and reduce complications in colorectal cancer patients during the COVID-19 era?
Cohort (n=918)
No
Does enhanced recovery after surgery (ERAS) improve short-term outcomes and reduce complications in colorectal cancer patients during the COVID-19 era?
ERAS protocols significantly reduce postoperative complications and hospital costs for colorectal cancer patients even during the COVID-19 pandemic.
Answers are grounded in this paper and cite their sources.
ERAS may reduce complications after colorectal cancer surgery; leaves open confirmation by randomized trials in pandemic settings.
Purpose: To figure out whether enhanced recovery after surgery (ERAS) could effectively improve the prognosis of colorectal cancer (CRC) patients and reduce hospitalization expenses under the shadow of COVID-19, furthermore to alleviate the current situation of medical resource for the whole society. Methods: Patients who underwent CRC surgery in the department of gastrointestinal surgery of the First Affiliated Hospital from January 2020 to March 2022 were retrospectively enrolled. According to protocol adherence, all patients were divided into the ERAS group and the non-ERAS group. Short-term outcomes were compared between the two groups. Results: A total of 918 patients were enrolled in the study. Based on protocol adherence ≥70%, 265 patients were classified into the ERAS group and the other 653 patients were classified into the non-ERAS group. Patients in the ERAS group had shorter operation time ( P < .01), less intraoperative blood loss ( P < .01), shorter overall hospital stay ( P < .01) and postoperative hospital stay ( P < .01), less hospital costs ( P < .01), earlier first flatus ( P < .01), earlier first stool ( P < .01), earlier food tolerance ( P < .01), and lower postoperative complications ( P < .01). Univariate and multivariate logistic regression analysis manifested that ERAS and cerebrovascular disease were predictive factors of postoperative overall complications. In univariate analyses, cerebrovascular disease ( P = .033, OR = 2.225, 95% CI = 1.066–4.748), time of the surgery ( P = .026, OR = 1.417, 95% CI = 1.043–1.925), and ERAS ( P < .01, OR = 0.450, 95% CI = 0.307–0.661) were predictive factors. Furthermore, in the multivariate analysis, ERAS ( P < .01, OR = 0.440, 95% CI = 0.295–0.656) and cerebrovascular disease ( P = .016, OR = 2.575, 95% CI = 1.190–5.575) were independent predictive factors of postoperative overall complications. Conclusion: In summary, under the impact of the COVID-19 pandemic, ERAS could still reduce the financial burden of patients and reduce the incidence of short-term postoperative complications. However, whether the effects of ERAS were enhanced after the pandemic and the long-term outcomes of CRC obey ERAS remained to be further explored.
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Tan et al. (2022) conducted a cohort in Colorectal cancer (n=918). Enhanced recovery after surgery (ERAS) vs. Non-ERAS was evaluated on Postoperative overall complications (OR 0.440, 95% CI 0.295-0.656, p=< .01). Enhanced recovery after surgery (ERAS) was independently associated with a reduced risk of postoperative overall complications in colorectal cancer patients (OR 0.440; 95% CI 0.295-0.656; P<0.01).
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