Background: The enhanced recovery after surgery (ERAS) protocol, an evidence-based perioperative strategy, has been proven in reduces the postoperative length of stay and perioperative complications rates in colorectal surgery. The implementation of ERAS defined by 15 components. However, the evaluation of ERAS component that have been applied to the outcomes in unclear.
Methods: A retrospective study was performed on 63 patients who undergone elective colorectal surgery based on ERAS protocol from January 2015 to December 2017 at Cipto Mangunkusumo Hospital. Patient characteristics, demographic, clinical findings, and length of stay (LOS) colleted from medical records. The relationship between the number of ERAS that accomplish and LOS was analyzed.
Result:All patients implemented up to 11 of 15 ERAS components. The mean age of the patients was 53 years old; 46% of patients were males, and 54% were females. There were no mortality rates. The morbidity rate was 7.9%, caused by surgical site infection 1.6%, pneumonia 1.6%, and urinary retention 4,8%. The most common location for colorectal tumour and procedure were sigmoid (47,6%) and colostomy closure (25,4%). There was a relationship between the total ERAS component protocols and the average length of stay (p
Conclusion: The higher number of ERAS components applied to one patient, the shorter LOS for postoperative care needed.
- Aarts M, Okrainec A, McCluskey S, Siddiqui N, Wood T, Pearsal E, et al. Enhanced Recovery After Surgery Guideline. Toronto; 2014. Available from: http://www.sages.org
- Ljungqvist O. Enhanced Recovery After Surgery: Moving Evidence-Based Perioperatif Care to Practice. North DakotaJPEN J Parenter Enteral Nutr. 2014. Available from: http://pen.sagepub.com
- Ramirez JM, Blasco JA, Roig JV, Martinez S, Casal JE, Esteban F, et al. Enhanced Recovery in Colorectal Surgery: a Multicentre Study. BMC Surg. 2011:11-9.
- Abraham N, Albayati S. Enhanced Recovery After Surgery programs hasten recovery after colorectal resections. Australia. World J Gastrointest Surg. 2011;1-6i
- MacFie J, Hon. Enhanced Recovery Protocols: An Update. Great Britain and Ireland. Clin Nutr. 2013;1:4-8
- Khan S, Gatt M, Horgan A, Anderson L, MacFie J. Guidelines for Implementation of Enhanced Recovery Protocols. Great Britain and Ireland; 2009. Available from: http://www.asgbi.org.uk
- Grigoraz I. Fast Track Surgery A new Concept the Perioperatif Anesthetic Management. J Chir. 2007;2:1584 – 9341.
- Mohamed I, Abdel A, Hatata Y, Bolous ML. Evaluation of An Enchanced Recovery Program For Elective Open Colorectal Cancer Surgery. Egypt J Surg. 2015;34:152-9.
- Ripolles-Melchor R, Varela ML, Camargo SC, Fernandez PJ, del Barrio AC, Gurumeta AA, et al. Enhanced recovery after surgery protocol versus conventional perioperative care in colorectal surgey. A single center cohort study. Spain: Rev Bras Anestesiol. 2018;64:358-68
- Gustafsson UO, Scott MJ, Schwenk W, Demartines N, Roulin D, Francis N, et al. Guidelines for Perioperative Care in Elective Colonic Surgery: Enhanced Recovery After Surgery Society Recommendations. The European Society for Clinical Nutrition and Metabolism, and International Assocation for Surgical Metabolism and Nutrition. World J Surg. 2013;37:259-284
- Jung AD, Dhar VK, Hoehn RS, Atkitson SJ, Johnson BL, Rice T, et al. Enhanced Recovery after Colorectal Surgery: Can We Afford Not to Use It? J Am Coll Surg. 2018;12:1-8
- Bray MS, Appel AL, Kalles KJ, Borgert AJ, Zinnel BA, Shapiro SB. Implementation of an Enhanced Recovery After Surgery Program for Colorectal Surgery at a Community Teaching Hospital. Wisconsin Medical Society. WMJ. 2017;116:1
- Carmichael JC, Keller DS, Baldini G, Bordeianou L, Weiss E, Lee L, et al. Clinical Practice Guidelines for Enhanced Recovery After Colon and Rectal Surgery From the American Society of Colon and Rectal Surgeons and Society of American Gastrointestinal and Endoscopic Surgeon. ASCRS. Dis Col Rec. 2017;60:761-84
- Elias KM. Understanding Enhanced Recovery After Surgery Guidelines: An Introductory Approach. J Laparoendosc Adv Surg Tech A. 2017;27:9
- Nanavati AJ, Prabhakar S. Enhanced Recovery After Surgery: If You Are Not Implementing it, Why Not? Nutrition issues in gastroenterology. Nutrition 2016:151
- Roulin D, Muradbegovic M, Addor V, Blanc C, Demartines N, Hubner M. Enhanced Recovery after Elevtive Colorectal Surgery-Reason for Non-Compliance with the Protocol. Dig Surg. 2016;33:220-26
- Scott MJ, Baldini G, Fearon KC, Feldheiser A, Feldman LS, Gan TJ, et al. Enhanced Recovery After Surgery for gastrointestinal surgery, part 1: pathophysiological considerations. Acta Anaesthesiol Scand 2015;59:1212-31
- Subramaniam D, Horgan AF. Enhanced recovery after colorectal surgery: an update on current practice. J mpsur. 2016;11:012
Jeo, Wifanto S.; Mazni, Yarman; and Suryadi, Andre S.
"Evaluation of the Implementation of ERAS Protocol in Colorectal Surgery at dr. Cipto Mangunkusumo General Hospital, Jakarta,"
The New Ropanasuri Journal of Surgery: Vol. 5
, Article 5.
Available at: https://scholarhub.ui.ac.id/nrjs/vol5/iss1/5