Did the ERAS protocol affect our results in colorectal surgery?

Abstract

Purpose: “Enhanced Recovery After Surgery” protocol has been practiced in our clinic for elective colorectal operations since 2006. This protocol was developed for accelerating healing and shortening hospital stay. Our purpose was to examine the effects of the protocol on the duration of hospital stay, oral feeding and gastrointestinal tolerance, and to compare our results with the literature.

Materials and Methods: Prospectively recorded data of 90 patients, of whom 26 had elective rectum and 64 had elective colonic procedures, were inspected for the oral feeding time, duration of hospital stay, complications related to the operation, gastrointestinal tolerance, and mortality. Our results were compared with the literature.

Results: All the patients were given water orally on the operation day after surgery. The mean time for starting oral feeding was 29 hours postoperatively for the patients who had colonic operations and 30 hours for those who had rectum operations. Seven patients had anastomotic leakage, 3 had evisceration, 3 had ileus and 1 had internal herniation. Four patients died postoperatively. Two of these patients were operated for rectal carcinoma, and 2 for colonic pathologies. Three patients died because of anastomotic leakage and one due to cardiac causes.

Conclusion: The practice of “Enhanced Recovery After Surgery” protocol in our clinic enabled early oral feeding, with a shortened length of stay when compared to the patients followed by a traditional approach and there was no increase in major complications such as anastomotic leakage and ileus in colorectal procedures. However, our results fell short of our goals.