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Enhanced recovery after surgery (ERAS) pathway vs traditional care in laparoscopic rectal resection: a single-center experience

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Abstract

Background

The aim of this study was to compare the outcome of an enhanced recovery after surgery (ERAS) pathway with traditional perioperative care in laparoscopic rectal resection.

Methods

A retrospective analysis of prospectively collected data was conducted. Single-center consecutive patients who underwent laparoscopic rectal surgery after an ERAS program were compared with patients who received traditional care over an 8-year period. Primary and total length of stay, and readmission, morbidity and mortality rates were analyzed. For ERAS group, the actual adherence to protocol was also evaluated.

Results

Two hundred and ninety-seven patients, 162 in the ERAS group and 135 in conventional care, were studied. Median primary and total length of stay were significantly shorter in the ERAS group (9 vs 12 days; p = 0.0001; 10 vs 12 days; p = 0.01; respectively). The ERAS group experienced a faster recovery of bowel function than the traditional care group (p = 0.0001). A similar morbidity rate was observed in the two groups (32.3 % in ERAS vs 36.1 % in traditional care p = 0.41). Readmission rates were 4.9 % in the ERAS versus 1.5 % in the traditional care group (p = 0.19). There was no mortality in either group. Overall mean compliance with the ERAS protocol was 85.7 % (range 54.4–100 %).

Conclusions

The introduction of the ERAS protocol in laparoscopic rectal resection led to a reduction in primary and total length of hospital stay without an increase in morbidity or readmission rates when compared to traditional care.

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Acknowledgments

We thank Miss Sharon O Neill for her help in reviewing the English language of the manuscript and Giovanni Radaelli MD, PhD from Department of Biometry and Statistics of the University of Milan for his contribution.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Vita e salute University, Via Olgettina 60, 20132, Milan, Italy

    A. Vignali, U. Elmore, A. Cossu, M. Lemma, P. de Nardi & R. Rosati

  2. Department of General and Minimally-Invasive Surgery, Humanitas Research Hospital, University of Milan, Rozzano, Milan, Italy

    B. Calì

Authors
  1. A. Vignali
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  2. U. Elmore
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  3. A. Cossu
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  4. M. Lemma
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  5. B. Calì
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  6. P. de Nardi
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  7. R. Rosati
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Correspondence to A. Vignali.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained form all individual participant included in the study.

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Vignali, A., Elmore, U., Cossu, A. et al. Enhanced recovery after surgery (ERAS) pathway vs traditional care in laparoscopic rectal resection: a single-center experience. Tech Coloproctol 20, 559–566 (2016). https://doi.org/10.1007/s10151-016-1497-4

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  • DOI: https://doi.org/10.1007/s10151-016-1497-4

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