Comparative study between enhanced recovery after surgery and traditional care pathways in elective laparoscopic colonic surgery at two teaching hospitals in Cairo

Background
The delay until full recovery after colorectal surgery has been greatly improved by the introduction of an evidence-based postoperative management program. Enhanced recovery after colorectal surgery (ERAS) program has been covering the entire perioperative period and formulated into a standardized protocol.
Objective
The study assessed the feasibility of application of the ERAS system in Maadi Armed Forces and Ain Shams University hospitals, trying to establish a core unit, team, and a protocol for evidence-based perioperative care of our patients.
Patients and methods
This was a prospective comparative study conducted on 53 colorectal surgery patients to compare patients within ERAS program with patients with conventional perioperative care. The two groups were similar regarding age, comorbidities, operative time and technique, and intraoperative blood loss.
Results
There was a highly significant decrease in ICU and hospital stays in the ERAS group compared with the traditional care group. There was a highly significant decrease in visual analog scale score in the ERAS group compared with the traditional care group. There was a highly significant decrease in the early readmission rate in the ERAS group compared with the traditional care group. There was a highly significant increase in immediate postoperative albumin in the ERAS group compared with the traditional care group. There was a highly significant increase in follow-up postoperative albumin in the ERAS group compared with the traditional care group.
Conclusion
On the basis of the current data, it appears that ERAS program is feasible and can be implemented in our hospitals. Moreover, it resulted in an overall improvement in postoperative outcomes. ERAS patients were found to have shorter length of hospital stay, less overall postoperative complication rate, and better postoperative nutrition status. However, further studies are needed to be conducted on a bigger sample of patients to prove reproducibility and reliability.