Baylor Scott & White Memorial Hospital Temple, TX, USA.
Baylor Scott & White Memorial Hospital Temple, TX, USA.
Am J Surg. 2024 Dec;238:115835. doi: 10.1016/j.amjsurg.2024.115835. Epub 2024 Jul 16.
Surgical dogma suggests that enhanced recovery (ERAS) pathways are not feasible in the non-elective setting. This study challenges that dogma with the implementation of ERAS in non-elective colorectal surgery.
Single center review of all colorectal operations was performed following implementation of ERAS in non-elective colorectal surgery. Compliance and outcomes between elective and non-elective operations were compared.
142 elective and 116 non-elective operations were performed with a compliance rate of 84 % and 46 %, respectively. Acceptable compliance was achieved with 7 metrics in the non-elective cohort. Elective operations were associated with an average LOS of 3 days and a 1 % SSI rate, compared to 8 days and 15 % in the non-elective group. On multivariate analysis, five ERAS metrics were associated with SSI.
ERAS pathways are often neglected in non-elective surgery. Acute Care Surgeons should recognize the ERAS principles that are appropriate for their patient population and implement these strategies into practice.
外科教条认为，强化康复（ERAS）途径在非择期情况下不可行。本研究通过在非择期结直肠手术中实施 ERAS 来挑战这一教条。
在非择期结直肠手术中实施 ERAS 后，对所有结直肠手术进行了单中心回顾。比较了择期和非择期手术的依从性和结果。
共进行了 142 例择期和 116 例非择期手术，其依从率分别为 84%和 46%。非择期组有 7 项指标达到了可接受的依从性。择期手术的 LOS 平均为 3 天，SSI 发生率为 1%，而非择期组分别为 8 天和 15%。多变量分析显示，5 项 ERAS 指标与 SSI 相关。
ERAS 途径在非择期手术中经常被忽视。急性护理外科医生应认识到适合其患者人群的 ERAS 原则，并将这些策略付诸实践。
