ERAS protocol in laparoscopic colon surgery: evaluation of an initial series

Abstract

Background: ERAS protocols are measures to improve perioperative care. Its application in conventional colorectal surgery should be considered the new standard; its advantages are discussed in laparoscopic surgery.
Objectives: to evaluate the applicability of ERAS in laparoscopic colorectal surgery. Secondary objective: comparative analysis of early results.
Method: the applicability of all steps of the protocol was evaluated. The variables compared were liquid handling, tolerance of diet, intestinal transit, days of hospitalization, complications, mortality and readmission rate.
Results: Group A: 8.57%, referred not to have fully understood the protocol, 25.71% did not meet preoperative indications. 28.5% had no epidural catheter. 80% of patients received adequate hydra- tion. 43% did not ingest the preparation of carbohydrates. 80% received food early;mobilization was delayed in 28.5%. Intraoperative fluid infusion in-group A was significantly lower than controls. Group A tolerated liquids and solids earlier than controls. In-group B one liter over parenteral hydration was used during hospitalization. Patients in-group A had catharsis earlier than controls. Overall morbidity was not significant. The length of stay was significantly lower in-group A. The readmission was similar. There was no mortality.
Conclusion: it is possible and safe to apply an ERAS protocol in laparoscopic colectomy with an acceptable compliance in our hospital. With a faster discharge and the same rate of readmissions.