Clinical outcome of the implementation of enhanced recovery after surgery protocol in colorectal surgery

الملخص EN

Introduction: The aim of this study was to present the benefit of implementing enhanced recovery after surgery (ERAS) protocol on all patients who underwent elective colorectal surgery and its influence on clinical outcome, by comparing this result with traditional perioperative care TPC).

Methods: This is a retrospective analysis of a prospectively maintained database.

All patients who underwent elective colorectal surgery at the colorectal unit from July 2014 to August 2018 for different colorectal diseases were included.

Data collected were demographics, American Society of Anesthesia (ASA) score, body mass index (BMI), Clavien Dindo classification for grading of surgical complications, length of hospital stay, postoperative morbidity and mortality.

Result: Three hundred and fifty-four patients were included in this study, with a minimum follow up of 30 days.

227 patients managed after implementation of the ERAS program were compared with127 patients managed with TPC.

Half were females (49.4%) with a mean age of 54.6 years (range 16-84 years).

The average length of stay decreased from 5.84 days SD-+ 2.77 in TPC to 3.88 days SD-+1.86 in the ERAS (P = 0.001) and morbidity decreased from 25.1% to 14.1%, (P=0.028) with the mortality slightly increased from 1.

6% in TPC to 2.2% after implementation of ERAS (P =0.63).

Conclusion: Implementation of ERAS protocol is very useful to improve the healthcare outcome and reducing the length of stay in the hospital and postoperative morbidity, and this in keeping with the international literature.

So we recommend using it on all patients undergoing elective colorectal surgeries specifically and on all surgical patients generally