ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOLS: IMPACT ON PATIENT OUTCOMES AND HOSPITAL STAY IN GASTROINTESTINAL SURGERIES.

Abstract

Background: ERAS is now defined as systematic, evidence based, multidisciplinary ‘best-practice’ pathways to minimise the physiological impact of surgery and promote the most efficient postoperative recovery. Inomas described classical techniques in the gastrointestinal surgeries that may result in hospitalization period and postoperative complications. These problems are addressed by the ERAS standards for improved preoperative, intraoperative, and postoperative care outcomes, with a short recovery period and fewer complications.

Objectives: In this clinical study, the researcher used a pre-test and post-test survey method to assess the effect of the ERAS protocols in 150 subjects undergoing surgery andcompare it with the postoperative outcome such as complication rate and postoperative hospital stay. The objectives of this study are to analyze recovery speed and safety of the patient.

Study design : A prospective study.

Duration and place of study. Department of General Surgery Ziauddin Hospital from jan 2021 to july 2022

Methods: This prospective comparative study included 150 GIs, 75 of them treated according to ERAS and 75 – according to conventional protocol. Multiple parameters considering for assessment were postoperative complications, hospitalization period, and the time taken for recovery. Chi Square and t-tests were used to analyze the results, which were derived using a test of hypothesis that was set at p < 0.05. Hospital stay and complication rates were considered qualitatively; therefore, patient outcomes were measured by standard deviation to reflect variability.

Results: Patients treated in accordance with ERAS were discharged earlier within 4.2 ± 1.3 days of postoperative compared to traditional group within 6.1 ± 1.8 days, p < 0.01. The overall postoperative complications were also less in the ERAS group 15% than the Traditional group 27% p = 0.03. The outcome reveal that, the standard deviation for hospital stay difference was found to be 1.3 days among the patients in the ERAS group and 1.8 days in the standard group which demonstrates a higher level of variation among the latter group. These results indicate that the adoption of ERAS protocols and the minimization of its implementation variability has a positive effect on patients’perioperative outcome.

Conclusions: By the implementation of ERAS protocols, the hospital stay and postoperative complications of patients who have undergone gastrointestinal surgeries is cut down. This has the effect for decreasing fluctuation in patients’ recuperation and increasing the effectiveness of these protocols. It also has added benefits that could include increased efficiency and patient satisfaction and overall reduced healthcare expense if integrated generally as the ERAS system. Nevertheless, more investigation must be performed to achieve the ERAS Protocol uniformity across the various fields of surgery.