Why the study?
Enhanced Recovery After Surgery recommendations originate from high-flow academic centers, and their feasibility in low-flow centers needed demonstration.
Does the ERAS protocol reduce length of hospital stay and improve outcomes in patients undergoing elective colorectal surgery?
Does the ERAS protocol reduce length of hospital stay and improve outcomes in patients undergoing elective colorectal surgery?
Implementation of ERAS protocols in low-flow centers is feasible and significantly reduces hospital length of stay and post-operative pain without increasing complications.
ERAS may be feasible in low-volume colorectal centers; leaves open need for RCTs before practice change.
Background: Enhanced Recovery After Surgery guidelines in colorectal surgery state that there is improvement in general post-operative outcomes including reduction in operative complications and 30 days readmission rates. These recommendations were originating from high flow, excellence and academic centers. Aim and objectives: Demonstrating the feasibility of ERAS protocols application in low-flow centres as our hospital is the aim of this study. Materials and Method: A retrospective cohort study was performed at a tertiary hospital. A total of 99 patients were included over a period of 6 years from January 2014 till January 2020 for all elective colorectal cases after being filtered through inclusion and exclusion criteria. They were divided into two groups Pre-ERAS (n=29) and ERAS group (n=70) starting from August 2016 the date of beginning implementation of the local protocol. Results: It was observed that there was statistical significance in reducing the length of hospital stay from an average of 13 days in Pre-ERAS to average of 8 days in the ERAS group and a decrease in day 1 post-operative pain score were achieved without adverse impact in surgery related morbidities or readmission rate. Conclusion: ERAS protocol can be applied to improve surgical outcomes in colorectal surgery without increased risk of complications.
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AlBaroudi et al. (2022) studied this question.
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