ENHANCED RECOVERY AFTER SURGERY(ERAS)PROTOCOLS VS. STANDARD CARE IN PATIENTS WITH PEPTIC ULCER PERFORATION

Abstract

Objectives: To compare the efficacy of Enhanced recovery after surgery(ERAS) protocol vs standard care in patients with perforated peptic ulcer (PPU). Materials and Methods: This single-center, retrospective, cross-sectional study was carried out from January 2021 to January 2022. Patients with PPU undergoing Grahams repair were divided into standard care and ERAS group. Primary outcome was the duration of stay. Secondary outcomes were functional recovery parameters and morbidity. Results: A total of 120 cases of PPU were admitted in our hospital, among which 60 patients each were included in standard care and ERAS group, respectively. Patients in ERAS group had a significantly early functional recovery for the time to first flatus (1.41 vs 2.38 p < 0.001), first stool (2.65 vs 3.78 p < 0.001), first fluid diet (2.75 vs 6.1 p < 0.001), and solid diet (4.08 vs 7.11 p < 0.001). Duration of stay in ERAS group was significantly shorter (6.2 vs 8.53 p < 0.001). There was a significant reduction in postoperative morbidity such as postoperative nausea and vomiting (RR 0.43, p value = 0.005), superficial SSI (RR 0.4, p = 0.005) and pulmonary complications (RR 0.45, p = 0.002). Result : ERAS group showed better primary and secondary outcomes. Conclusion: In conclusion, ERAS protocols, are feasible and safe for application in selected patients undergoing Grahams repair of perforated peptic ulcer without an increase in the rate of complications.