Enhanced Recovery after Surgery (ERAS) in Patients Undergoing Colorectal Surgeries

Abstract Enhanced Recovery after Surgery (ERAS) is a collection of strategies that combine in a structured pathway allowing the surgical and anaesthetic teams to decrease the physical insult and aid recovery enabling earlier discharge. 222 patients undergoing elective colorectal surgery -106 cases and 116 controls were included in a prospective comparative study done over a period of two years. Patients were matched for age, gender, co-morbidity, type of disease, American Society of Anesthesiologists (ASA) grade, type of surgery and stoma formation. Primary outcome measures of this study were length of hospital stay, mortality and morbidity. Secondary outcome measures were early oral feeding, return of bowel functions and number of readmissions within 30 days. Mean post-operative hospital stay was 4 days for patients in ERAS group compared to 8.7 days for the control group. There was no significant difference between the ERAS and control group for morbidity (22.6% Vs 31.1%; P = 0.16) and mortality (0% Vs 0.86%; P > 0.05). Regular feeding was tolerated much earlier in ERAS group (3days Vs 7days; P = 0.00). Bowel functions returned earlier in ERAS group (2.9 days Vs 5.3 days; P = 0.00). Readmission within 30 days of discharge was higher for ERAS group (6.6% Vs 0%; P = 0.05). Treatment of colorectal surgery patients according to an enhanced recovery after surgery programme leads to faster recovery and shorter hospital stay. Principles of ERAS programme are applicable and will be most beneficial for the patients