ENHANCED RECOVERY AFTER SURGERY (ERAS) IN EMERGENCY COLORECTAL SURGERY
Abstract
Introduction: Enhanced recovery after surgery (ERAS) programs for elective colorectal surgery have been shown to decrease postoperative complication, shorten hospital stay, facilitate patient recovery, and lower healthcare cost. The question if ERAS programs applied in emergency colorectal surgery can have the same benefits still awaits a definitive answer. Material and method: We performed a prospective analysis of patients with complicated colorectal cancer admitted to our department between 2020 and 2023. ERAS protocol measures were applied to all patients. We studied the compliance with each item of the protocol. We selected the patients with a minimum of 12 ERAS measures applied. We compared them with a similar group selected from previous addmitions through a matching case process. We followed: GI recovery time, hospital stay, postoperative complications, overall morbidity, and mortality rates. Results: The rates of compliance were significantly lower for preoperative and postoperative measures in emergency when compared to elective surgery but similar for intraoperative measures. 63 patients that had a minimum of 12 ERAS measures applied. We compared them with the matched cases group. There was a significantly lower GI recovery time for patients in the ERAS group compared to non-ERAS patients. (mean values 54.4 hours vs. 75.2 hours). Also, the hospital stay was significantly lower for the ERAS Group (mean values 7.4 days vs. 10.8 days). Postoperative morbidity and mortality were similar in the two Groups. Conclusion: The ERAS program is associated with a faster GI recovery time and shorter length of hospital stay – without increased rates of morbidity and mortality after emergency colorectal surgery. Compliance with ERAS program in emergency surgery appears to be lower than in elective operations.
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