Programa Enhanced Recovery After Surgery en un hospital terciario portugués: una auditoría a los primeros 6 meses de implementación en cirugía colorrectal electiva

Abstract

Introduction and objectivesThe Enhanced Recovery After Surgery (ERAS) program consists in a multimodal strategy of optimize the recovery of the patient, reduce morbidity, length of hospital stay and hospital costs. The aim of this study was to evaluate the first six months compliance and clinical outcomes after implementation of the program in elective colorectal surgery in a tertiary hospital. Material and methodsAn analysis was performed on 209 patients who underwent elective colorectal surgery. The first 102 patients (pre-ERAS group) who underwent surgery between January and May 2018, before the implementation of the program, were compared to the 107 patients treated between May and October 2019, after ERAS implementation. The main outcomes were patient education and counselling, intravenous fluids, early mobilization, postoperative nausea and vomiting, return of bowel function, length of stay, complications, mortality and overall compliance. ResultsERAS program was associated with a significant increase in patient education and counselling (p<0.001) and with a significant reduction in intra and postoperative IV fluids volume (p=0.007 and p<0.001, respectively) and postoperative nausea or vomiting (17.6% vs 5.0%, p=0.007). Postoperative days to recover ADL (5.29 vs 2.85 days; p<0.001), time to solid oral intake (6.21 vs 4.35 days; p<0.001), time to first flatus (2.41 vs 1.51 days; p<0.001) and defecation (3.35 vs 1.66 days; p<0.001) decreased whit ERAS. There was no statistical difference in length of stay, complications and mortality. ConclusionThis study showed that ERAS program allowed to improve perioperative outcomes and postoperative recovery of colorectal patients in this hospital.