Marius Bica (Craiova / RO), Daniel Preda (Craiova / RO), Daniela Marinescu (Craiova / RO), Stefan Patrascu (Craiova / RO), Ion Georgescu (Craiova / RO), Marin Valeriu Șurlin (Craiova / RO)
Abstract text (incl. references and figure legends)
Introduction: Enhanced recovery after surgery (ERAS) programs have demonstrated unquestionable advantages for elective colorectal surgery. Up to 30% of colorectal operations are performed in emergency conditions. Can ERAS programs applied to patients having emergency colorectal surgery have the same benefits as in an elective setting?
Material and method: ERAS has been applied in our department for elective colorectal patients for more than 10 years. Most measures from the ERAS protocol have become standard and some are being applied for all patients, even emergency colorectal surgery patients. We performed a retrospective study for emergency colorectal surgery cases admitted in the past 3 years. 95 patients underwent emergency colorectal surgery in our department between 2019 and 2021. We studied patient"s compliance with each item of the ERAS protocol. We selected 63 patients that had a minimum of 12 ERAS measures applied. We compared this group of patients with a similar group selected from previous years admitions through a matching case process. The variables that we followed were GI recovery time, complications, hospital stay and cost and 30 day mortality.
Results: The highest compliance was registered for intraoperative ERAS measures. The lowest compliance rate was noted for preoperative measures. GI recovery time was significantly lower in the ERAS group (62.2 hours vs. 75.2 hours) as was the hospital stay (7.4 vs. 10.8 days). Complication rate and 30 day mortality rate ware similar in both groups.
Conclusions: Growing evidence demonstrating the safety, feasibility and benefits of ERAS program on surgical outcome following emergency colorectal surgery (more so for cases with no abdominal sepsis). The ERAS program is associated with a lower rate of overall complication and shorter length of hospital stay – without increased risks of readmission, reoperation and death after emergency colorectal surgery.
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