Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Department of Anesthesiology and Intensive Care Unit, Foisor Hospital Bucharest, 030167 Bucharest, Romania.
Medicina (Kaunas). 2024 Aug 15;60(8):1319. doi: 10.3390/medicina60081319.
Enhanced Recovery After Surgery (ERAS) represents evidence-based transformation in perioperative care, which has been demonstrated to reduce both recovery times and postoperative complication rates. The aim of the present study was to evaluate the clinical significance of the ERAS program in comparison with conventional postoperative care. This longitudinal cohort observational study enrolled 120 consecutive patients diagnosed with intestinal obstruction caused by colorectal cancers, with 40 patients in the ERAS group and 80 patients receiving conventional postoperative care forming the non-ERAS group. Our study compares the effectiveness of ERAS protocols to non-ERAS methods, focusing on the time to first flatus, defecation, the resumption of normal diet, and early mobilization. The main endpoints are morbidity and hospitalization length. The results showed that despite a longer admission-to-surgery interval in the ERAS group, median hospitalization was significantly shorter compared to the non-ERAS group ( = 0.0002). The ERAS group showed a tendency towards a lower incidence of overall postoperative complications, indicating that implementing the ERAS protocol does not increase the risk of postoperative complications, ensuring the safety of enhanced recovery strategies for patients. Also, ERAS patients had notably fewer stomas than those in the non-ERAS group, indicating the potential effectiveness of reducing stoma necessity. This study shows that ERAS surpasses conventional care for colonic or rectal surgery patients, reducing hospital stays and costs while enhancing recovery. This highlights the comprehensive advantages of adopting ERAS in surgical settings.
加速康复外科（ERAS）代表了围手术期护理的循证转变，已被证明可以减少恢复时间和术后并发症发生率。本研究旨在评估 ERAS 方案与常规术后护理相比的临床意义。这项纵向队列观察性研究纳入了 120 例连续诊断为结直肠癌引起肠梗阻的患者，其中 40 例患者在 ERAS 组，80 例接受常规术后护理的患者在非 ERAS 组。我们的研究比较了 ERAS 方案与非 ERAS 方法的有效性，重点关注首次排气、排便、恢复正常饮食和早期活动的时间。主要终点是发病率和住院时间。结果表明，尽管 ERAS 组的入院到手术间隔时间较长，但与非 ERAS 组相比，中位住院时间明显缩短（= 0.0002）。ERAS 组的总体术后并发症发生率较低，表明实施 ERAS 方案不会增加术后并发症的风险，确保了增强恢复策略对患者的安全性。此外，ERAS 组患者的造口数量明显少于非 ERAS 组，表明减少造口必要性的潜力。本研究表明，ERAS 优于结直肠手术患者的常规护理，可减少住院时间和费用，同时促进康复。这突出了在手术环境中采用 ERAS 的综合优势。
