In predefined subgroup analyses , findings did not vary by surgical approach ( open vs laparoscopic ) or colorectal condition .
CONCLUSIONS : Enhanced recovery protocol s for adults undergoing colorectal surgery improve patient outcomes with no increase in adverse events .
Evidence was insufficient regarding which components , or component combinations , are key to improving patient outcomes .
BACKGROUND : Enhanced surgical recovery protocol s are design ed to reduce hospital length of stay and health care costs .
OBJECTIVE : This study aims to systematic ally review and summarize evidence from r and omized and controlled clinical trials comparing enhanced recovery protocol s versus usual care in  adults undergoing elective colorectal surgery with emphasis on recent trials , protocol components , and subgroups for surgical approach and colorectal condition .
Safety and efficacy of an “enhanced recovery after surgery” protocol for patients undergoing colon cancer surgery: a multi-institutional controlled study
Purpose The aim of this multi-institutional study was to prospect ively evaluate the safety and efficacy of an enhanced recovery after surgery ( ERAS ) protocol for colonic surgery . Methods The subjects of this study were 320 patients with an American Society of Anesthesiologists ( ASA ) grade I or II physical status . Patients underwent elective open or laparoscopic colonic resection or high anterior resection between April 2011 and January 2014 at one of six institutions . Three hospitals implemented an ERAS protocol ( n = 159 ) , and three administered conventional care ( n = 161 ) . The primary outcome measure was the surgical complication rate . Results Most operations , irrespective of group , were performed laparoscopically . The incidence of a surgical complication was 17.0 % in the ERAS group vs. 16.1 % in the conventional group ( P = 0.842 ) , in which several non-surgical complications also arose . Oral food intake was implemented earlier for the ERAS group vs. the conventional group , after a median ( range ) of 1 ( 1–31 ) vs. 3 ( 1–9 ) days for the ERAS vs. conventional care groups , respectively ( P < 0.001 ) . The median length of postoperative hospital stay was reduced by 5.5 days for the ERAS group , being 8.5 ( 5–41 ) vs. 14 ( 7–56 ) days for the ERAS vs. conventional care groups , respectively ( P < 0.001 ) . Conclusion This multi-institutional controlled study clearly demonstrated that an ERAS protocol was efficient , without increasing the complication risk
In predefined subgroup analyses , findings did not vary by surgical approach ( open vs laparoscopic ) or colorectal condition .
CONCLUSIONS : Enhanced recovery protocol s for adults undergoing colorectal surgery improve patient outcomes with no increase in adverse events .
Evidence was insufficient regarding which components , or component combinations , are key to improving patient outcomes .
BACKGROUND : Enhanced surgical recovery protocol s are design ed to reduce hospital length of stay and health care costs .
OBJECTIVE : This study aims to systematic ally review and summarize evidence from r and omized and controlled clinical trials comparing enhanced recovery protocol s versus usual care in  adults undergoing elective colorectal surgery with emphasis on recent trials , protocol components , and subgroups for surgical approach and colorectal condition .