Skip to main content

ERAS in Colorectal Surgery

  • Chapter
  • First Online:
  • 3070 Accesses

Abstract

The ERAS collaboration all started in colorectal surgery. This chapter explains why a new perioperative regime was particularly necessary within this field of surgery and also gives an overview of all the items within the ERAS protocol, how to understand compliance to the items, and why they are all important to audit. Finally, future opportunities to investigate new surgical and treatment methods within the excellent environment provided by the ERAS prptocol will be dicussed.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Birkmeyer JD, Dimick JB, Staiger DO. Operative mortality and procedure volume as predictors of subsequent hospital performance. Ann Surg. 2006;243(3):411–7.

    Article  Google Scholar 

  2. Khuri SF, Henderson WG, Daley J, Jonasson O, Jones RS, Campbell DA Jr, et al. The patient safety in surgery study: background, study design, and patient populations. J Am Coll Surg. 2007;204(6):1089–102.

    Article  Google Scholar 

  3. Main DS, Henderson WG, Pratte K, Cavender TA, Schifftner TL, Kinney A, et al. Relationship of processes and structures of care in general surgery to postoperative outcomes: a descriptive analysis. J Am Coll Surg. 2007;204(6):1157–65.

    Article  Google Scholar 

  4. Bokey EL, Chapuis PH, Fung C, Hughes WJ, Koorey SG, Brewer D, et al. Postoperative morbidity and mortality following resection of the colon and rectum for cancer. Dis Colon Rectum. 1995;38(5):480–6; discussion 6–7.

    Article  Google Scholar 

  5. Muller S, Zalunardo MP, Hubner M, Clavien PA, Demartines N. A fast-track program reduces complications and length of hospital stay after open colonic surgery. Gastroenterology. 2009;136(3):842–7.

    Article  Google Scholar 

  6. Serclova Z, Dytrych P, Marvan J, Nova K, Hankeova Z, Ryska O, et al. Fast-track in open intestinal surgery: prospective randomized study (Clinical Trials Gov Identifier no. NCT00123456). Clin Nutr. 2009;28(6):618–24.

    Article  Google Scholar 

  7. Wind J, Polle SW, Fung Kon Jin PH, Dejong CH, von Meyenfeldt MF, Ubbink DT, et al. Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg. 2006;93(7):800–9.

    Article  CAS  Google Scholar 

  8. Basse L, Raskov HH, Hjort Jakobsen D, Sonne E, Billesbolle P, Hendel HW, et al. Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. Br J Surg. 2002;89(4):446–53.

    Article  CAS  Google Scholar 

  9. Maessen J, Dejong CH, Hausel J, Nygren J, Lassen K, Andersen J, et al. A protocol is not enough to implement an enhanced recovery programme for colorectal resection. Br J Surg. 2007;94(2):224–31.

    Article  CAS  Google Scholar 

  10. Dindo D, Hahnloser D, Clavien PA. Quality assessment in surgery: riding a lame horse. Ann Surg. 2010;251(4):766–71.

    Article  Google Scholar 

  11. Russell EM, Bruce J, Krukowski ZH. Systematic review of the quality of surgical mortality monitoring. Br J Surg. 2003;90(5):527–32.

    Article  CAS  Google Scholar 

  12. Spanjersberg WR, Reurings J, Keus F, van Laarhoven CJ. Fast track surgery versus conventional recovery strategies for colorectal surgery. Cochrane Database Syst Rev. 2011;2:CD007635.

    Google Scholar 

  13. Varadhan KK, Lobo DN. A meta-analysis of randomised controlled trials of intravenous fluid therapy in major elective open abdominal surgery: getting the balance right. Proc Nutr Soc. 2010;69(4):488–98.

    Article  Google Scholar 

  14. Hounsome J, Lee A, Greenhalgh J, Lewis SR, Schofield-Robinson OJ, Coldwell CH, et al. A systematic review of information format and timing before scheduled adult surgery for peri-operative anxiety. Anaesthesia. 2017;72(10):1265–72.

    Article  CAS  Google Scholar 

  15. Forsmo HM, Pfeffer F, Rasdal A, Ostgaard G, Mohn AC, Korner H, et al. Compliance with enhanced recovery after surgery criteria and preoperative and postoperative counselling reduces length of hospital stay in colorectal surgery: results of a randomized controlled trial. Color Dis. 2016;18(6):603–11.

    Article  CAS  Google Scholar 

  16. Powell R, Scott NW, Manyande A, Bruce J, Vogele C, Byrne-Davis LM, et al. Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database Syst Rev. 2016;(5):CD008646.

    Google Scholar 

  17. Thomsen T, Villebro N, Moller AM. Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. 2014;27(3):CD002294.

    Google Scholar 

  18. Shabanzadeh DM, Sorensen LT. Alcohol consumption increases post-operative infection but not mortality: a systematic review and meta-analysis. Surg Infect. 2015;16(6):657–68.

    Article  Google Scholar 

  19. Wilson RJ, Davies S, Yates D, Redman J, Stone M. Impaired functional capacity is associated with all-cause mortality after major elective intra-abdominal surgery. Br J Anaesth. 2010;105(3):297–303.

    Article  CAS  Google Scholar 

  20. Barberan-Garcia A, Ubre M, Roca J, Lacy AM, Burgos F, Risco R, et al. Personalised Prehabilitation in high-risk patients undergoing elective major abdominal surgery: a randomized blinded controlled trial. Ann Surg. 2018;267(1):50–6.

    Article  Google Scholar 

  21. Jie B, Jiang ZM, Nolan MT, Zhu SN, Yu K, Kondrup J. Impact of preoperative nutritional support on clinical outcome in abdominal surgical patients at nutritional risk. Nutrition. 2012;28(10):1022–7.

    Article  Google Scholar 

  22. Smilowitz NR, Oberweis BS, Nukala S, Rosenberg A, Zhao S, Xu J, et al. Association between anemia, bleeding, and transfusion with long-term mortality following noncardiac surgery. Am J Med. 2016;129(3):315–23 e2.

    Article  Google Scholar 

  23. Acheson AG, Brookes MJ, Spahn DR. Effects of allogeneic red blood cell transfusions on clinical outcomes in patients undergoing colorectal cancer surgery: a systematic review and meta-analysis. Ann Surg. 2012;256(2):235–44.

    Article  Google Scholar 

  24. Gan TJ, Diemunsch P, Habib AS, Kovac A, Kranke P, Meyer TA, et al. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118(1):85–113.

    Article  Google Scholar 

  25. Nelson RL, Gladman E, Barbateskovic M. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2014;9(5):CD001181.

    Google Scholar 

  26. Rollins KE, Javanmard-Emamghissi H, Lobo DN. Impact of mechanical bowel preparation in elective colorectal surgery: a meta-analysis. World J Gastroenterol. 2018;24(4):519–36.

    Article  Google Scholar 

  27. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108(1):71–7.

    Article  Google Scholar 

  28. Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372(14):1324–32.

    Article  CAS  Google Scholar 

  29. Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG, et al. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg. 2013;100(1):75–82.

    Article  CAS  Google Scholar 

  30. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26.

    Article  Google Scholar 

  31. Vlug MS, Wind J, Hollmann MW, Ubbink DT, Cense HA, Engel AF, et al. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study). Ann Surg. 2011;254(6):868–75.

    Article  Google Scholar 

  32. Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, et al. Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA. 2017;318(16):1569–80.

    Article  Google Scholar 

  33. Klahr S, Miller SB. Acute oliguria. N Engl J Med. 1998;338(10):671–5.

    Article  CAS  Google Scholar 

  34. Gustafsson UO, Thorell A, Soop M, Ljungqvist O, Nygren J. Haemoglobin A1c as a predictor of postoperative hyperglycaemia and complications after major colorectal surgery. Br J Surg. 2009;96(11):1358–64.

    Article  CAS  Google Scholar 

  35. Gustafsson UO, Hausel J, Thorell A, Ljungqvist O, Soop M, Nygren J, et al. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg. 2011;146(5):571–7.

    Article  Google Scholar 

  36. Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a retrospective cohort study. World J Surg. 2016;40(7):1741–7.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ulf O. Gustafsson .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Gustafsson, U.O. (2020). ERAS in Colorectal Surgery. In: Ljungqvist, O., Francis, N., Urman, R. (eds) Enhanced Recovery After Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-33443-7_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-33443-7_40

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-33442-0

  • Online ISBN: 978-3-030-33443-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics