Compliance analysis of enhanced recovery after surgery in patients with colorectal cancer

Abstract

Objective To explore whether it is beneficial to improve the short-term prognosis of patients undergoing colorectal surgery when enhanced recovery after surgery (ERAS) program was adopted before, during, and after the operation. Methods A total of 411 patients with colorectal cancer who underwent surgeryat our department from May 1st, 2015 to April 30th, 2018 were collected. An ERAS program and its implementation strategies were developed. The concept of compliance was defined. The baseline demographic data and adherence data of ERAS sub-scenarios were prospectively collected. A binary logistic regression analysis was used to assess the relationship between optimal recovery and compliance with ERAS entries. The independent effects of preoperative, intraoperative, and postoperative care compliance on optimal recovery were assessed in a separate model. Results The patients undergoing laparoscopic surgery had high adherence to the ERAS regimen, with a statistical difference from the patients undergoing open surgery (P<0.01) . The adherence rate of the implementation plan after the operation was only 40.6%. In the case of patient basic characteristics and disease distribution correction, optimal recovery correlated with overall compliance with the use of laparoscopic methods, anesthesia scores, and ERAS protocols. The compliance of the ERAS protocol after the operation was the key to the success of the entire ERAS protocol, with a 7-folded correlation with optimal recovery [OR = 7.039 (4.481 to 11.060) , P<0.001]. Conclusion The ERAS program after oepration is the most important part of the ERAS concept implementation. The ERAS concept can promote patient recovery both during and after laparoscopic surgery, but the ERAS concept combined with laparoscopic surgery can benefit patients more. Key words: Colorectal cancer; Enhanced recovery after surgery; Hospitalization time; Compliance