IMPACT OF ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOLS ON POSTOPERATIVE RECOVERY AND HOSPITAL STAY IN COLORECTAL SURGERY

S NASEER; A GUL; SA SHAH; S KHAN; MU NAYAB; FA KHAN; R AHMAD

doi:10.54112/bcsrj.v2024i1.1102

Authors

S NASEER 1Department of Surgery, Jinnah Teaching Hospital Medical College Peshawar, Pakistan
A GUL Department of Surgery, MTI Lady Reading Hospital Peshawar, Pakistan
SA SHAH Department of Surgery, Jinnah Teaching Hospital, Peshawar, Pakistan
S KHAN Department of Surgery, Jinnah Teaching Hospital, Peshawar, Pakistan
MU NAYAB Department of ENT, Abbottabad Medical Complex, Pakistan
FA KHAN Department of Surgery, Abbottabad Medical Complex, Pakistan
R AHMAD Department of Neurosurgeon, Rahman Medical Institute Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.1102

Keywords:

Colorectal Surgery Enhanced Recovery After Surgery (ERAS) Postoperative Complications Length of Stay Bowel Function

Abstract

Classically, colorectal surgery implicates extended hospital stays with a long recovery period and also high postoperative morbidity. Objective: The study's primary purpose is to find the impact of enhanced recovery after surgery (ERAS) protocols on postoperative recovery and hospital stay in colorectal surgery. Methods: This prospective observational study was conducted at Lady Reading Hospital, Medical Teaching Institution (MTI), Khyber Pakhtunkhwa (KPK), from January 2021 to January 2024. Data were collected from 84 patients. Patients aged >18 years and scheduled for elective colorectal surgery were included in the study. Results: Data were collected from 84 patients with a mean age of 52.4 ± 12.6 years. Most patients were male (60%, n=50), and 40% (n=34) were female. The average body mass index (BMI) was 26.8 ± 3.5 kg/m². Of the total, 30% (n=25) had a history of smoking, and 20% (n=17) were diabetic. Time to normal bowel function was faster in the ERAS group (1.8 ± 0.6 days) versus the traditional group (3.5 ± 1.1 days, p=0.001). Similarly, the ERAS group had shorter hospital stays (4.2 ± 1.3 days vs. 7.1 ± 2.2 days, p=0.001) and fewer complications (14.3% vs. 33.3%, p=0.03). Conclusion: It is concluded that Enhanced Recovery After Surgery (ERAS) protocols significantly improve postoperative recovery and reduce hospital stays in colorectal surgery patients.

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References

Khatoon F, Mahmood MR, Obeidat ST, Alsatti MAM, Alanazi RSSA, Kabbos RSMA, et al. Assessment of perception, awareness about predictors of colorectal cancer of Hail Region Saudi Arabia population. Journal of Pharmaceutical Research International. 2021;32(47):14-24.

Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA surgery. 2017;152(3):292-8.

Liu VX, Rosas E, Hwang J, Cain E, Foss-Durant A, Clopp M, et al. Enhanced recovery after surgery program implementation in 2 surgical populations in an integrated health care delivery system. JAMA surgery. 2017;152(7):e171032-e.

Nelson G, Bakkum-Gamez J, Kalogera E, Glaser G, Altman A, Meyer LA, et al. Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations—2019 update. International Journal of Gynecologic Cancer. 2019;29(4).

Grass F, Hübner M, Demartines N, Hahnloser D. Surgery for colon cancer in 2021. Revue Medicale Suisse. 2021;17(743):1155-8.

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj. 2021;372.

Mazni Y, Syaiful RA, Ibrahim F, Jeo WS, Putranto AS, Sihardo L, et al. The enhanced recovery after surgery (ERAS) protocol implementation in a national tertiary-level hospital: a prospective cohort study. Annals of Medicine and Surgery. 2024;86(1):85-91.

Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, et al. Clinical practice guidelines for enhanced recovery after colon and rectal surgery from the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeons. Diseases of the Colon & Rectum. 2017;60(8):761-84.

Forsmo HM, Erichsen C, Rasdal A, Körner H, Pfeffer F. Enhanced recovery after colorectal surgery (ERAS) in elderly patients is feasible and achieves similar results as in younger patients. Gerontology and geriatric medicine. 2017;3:2333721417706299.

Li L, Jin J, Min S, Liu D, Liu L. Compliance with the enhanced recovery after surgery protocol and prognosis after colorectal cancer surgery: a prospective cohort study. Oncotarget. 2017;8(32):53531.

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2018;68(6):394-424.

Ibrahim AA, Moustafa RM, Moustafa AA, EL-Rabaa S, Salama Y. Enhanced recovery program (ERP) versus traditional care after elective left side colorectal cancer surgery. The Egyptian Journal of Hospital Medicine. 2018;72(8):5122-9.

Gustafsson U, Scott M, Hubner M, Nygren J, Demartines N, Francis N, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World journal of surgery. 2019;43:659-95.

Ripollés-Melchor J, Ramírez-Rodríguez JM, Casans-Francés R, Aldecoa C, Abad-Motos A, Logroño-Egea M, et al. Association between use of enhanced recovery after surgery protocol and postoperative complications in colorectal surgery: the postoperative outcomes within enhanced recovery after surgery protocol (POWER) study. JAMA surgery. 2019;154(8):725-36.

Jeo WS, Mazni Y, Suryadi AS. Evaluation of the Implementation of ERAS Protocol in Colorectal Surgery at dr. Cipto Mangunkusumo General Hospital, Jakarta. The New Ropanasuri Journal of Surgery. 2020;5(1):5.

Jeo WS, Subrata FH. The survival rate of colorectal cancer in dr. Cipto Mangunkusumo Hospital. The New Ropanasuri Journal of Surgery. 2020;5(2):4.

Seow-En I, Wu J, Yang LWY, Tan JSQ, Seah AWH, Foo FJ, et al. Results of a colorectal enhanced recovery after surgery (ERAS) programme and a qualitative analysis of healthcare workers’ perspectives. Asian Journal of Surgery. 2021;44(1):307-12.

Tan JKH, Ang JJ, Chan DKH. Enhanced recovery program versus conventional care after colorectal surgery in the geriatric population: a systematic review and meta-analysis. Surgical Endoscopy. 2021;35:3166-74.

Mathew G, Agha R. STROCSS 2021: strengthening the reporting of cohort, cross-sectional and case-control studies in surgery. IJS Short Reports. 2021;6(4):e35.

Rasilainen S, Tiainen T, Pakarinen M, Bumblyte V, Scheinin T, Schramko A. ERAS failure and major complications in elective colon surgery: common risk factors. Surgery in Practice and Science. 2022;10:100080