Enhanced Recovery After Surgery Versus Conventional Care in Colorectal Surgery: A Systematic Review of Randomized Controlled Trials

Enhanced Recovery After Surgery (ERAS) protocols have gained prominence in colorectal surgery as a means to improve patient outcomes and reduce postoperative recovery time. This systematic review evaluated the effectiveness of ERAS protocols compared to conventional perioperative care, focusing on postoperative morbidity and length of hospital stay (LOS). A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane CENTRAL for randomized controlled trials (RCTs) published up to April 2024. Studies included adult patients undergoing elective colorectal surgery and reported on LOS and postoperative complications. Three RCTs met the inclusion criteria. Two trials demonstrated statistically significant reductions in LOS in ERAS groups compared to controls (p = 0.001 and p = 0.021), while the third reported no significant difference but affirmed ERAS safety. None of the studies showed increased morbidity, readmission rates, or mortality associated with ERAS protocols. ERAS protocols are a safe and effective alternative to conventional perioperative care in colorectal surgery. They are consistently associated with reduced hospital stay and comparable complication rates, supporting their broader implementation to enhance recovery and healthcare efficiency.