Abstract
The impact of an enhanced recovery after surgery (ERAS) programme in emergency colorectal surgery has not yet been reported. The objective of this study was to evaluate the feasibility and the results of patients included in an ERAS protocol following emergency colon surgery for left colon perforation. For this purpose, patients with a low to moderate risk of mortality, according to a Peritonitis Severity Score (PSS), and treated with an ERAS protocol (ERAS group) after emergency surgery for left colon perforation were compared for a period of 40 months (March 2014–June 2017) with a control group of patients treated with conventional care (CC group) during the 38 months prior to implementation of the new ERAS protocol (January 2011–February 2014). The main endpoint was 90-day postoperative morbidity according to the Clavien–Dindo classification. Secondary endpoints included length of postoperative hospital stay, 90-day readmission rate, protocol compliance and mortality. Fifty patients were included in the study, 29 in the ERAS group and 21 in the CC group. There were no significant differences between the groups in the demographic data or in the operative characteristics. A reduction in the incidence of postoperative complications (20.7% vs. 38%; p > 0.05) and in the postoperative hospital stay (7.7 + /- 3.85 vs. 10.9 + /- 5.6 days; p = 0.009) were observed in the ERAS group. The 90-day readmission rate did not differ significantly between the two groups (2 vs. 1). No 90-day mortality was observed in either group. The ERAS group showed better results than the CC group in protocol compliance. We conclude that ERAS protocols are feasible and help to reduce morbidity and length of hospital stay without adversely affecting the rate of readmission or mortality.
Highlights
The impact of an enhanced recovery after surgery (ERAS) programme in emergency colorectal surgery has not yet been reported
No significant differences in compliance were found for six of the intra-operative items analysed, significant differences were found for nausea and vomiting prophylaxis (ERAS 18/29 vs. CC 6/21), monitored fluid optimisation (ERAS 11/29 vs. CC 0/21) and opiate use (ERAS 19/29 vs. CC 4/21; p < 0.05) in the ERAS group
Significant differences were found for all postoperative items in the ERAS group, including removal of the nasogastric tube before 12 postoperative hours (ERAS 23/29 vs. CC 0/2), mobilisation before 24 postoperative hours (ERAS 23/29 vs. CC 0/21), oral intake before 24 postoperative hours (ERAS 26/29 vs. CC 0/2), abdominal www.nature.com/scientificreports group (n = 29)
Summary
The impact of an enhanced recovery after surgery (ERAS) programme in emergency colorectal surgery has not yet been reported. The objective of this study was to evaluate the feasibility and the results of patients included in an ERAS protocol following emergency colon surgery for left colon perforation. Secondary endpoints included length of postoperative hospital stay, 90-day readmission rate, protocol compliance and mortality. We conclude that ERAS protocols are feasible and help to reduce morbidity and length of hospital stay without adversely affecting the rate of readmission or mortality. The results of several multicentre studies[1,2], controlled and randomised trials[3], and corresponding meta-analyses[4,5] have shown significant reductions in morbidity and postoperative hospital stays when applying these programmes compared to outcomes when applying conventional perioperative care in patients undergoing elective colorectal surgery.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
