Other outcome parameters were unsuitable for meta- analysis , but seemed to favour ERAS .
Analysis shows a reduction in overall complications , but major complications were not reduced .
Length of stay was reduced significantly .
We state that ERAS seems safe , but the quality of trials and lack of sufficient other outcome parameters do not justify implementation of ERAS as the st and ard of care .
Within ERAS protocol s included , no answer regarding the role for minimally invasive surgery ( i.e. laparoscopy ) was found .
BACKGROUND In recent years the Enhanced Recovery after Surgery ( ERAS ) postoperative pathway in (ileo-)colorectal surgery , aim ing at improving perioperative care and decreasing postoperative complications , has become more common .
OBJECTIVES We investigated the effectiveness and safety of the ERAS multimodal strategy , compared to conventional care after (ileo-)colorectal surgery .
The primary research question was whether ERAS protocol s lead to less morbidity and secondary whether length of stay was reduced .
Prospective, Randomized, Controlled Trial Between a Pathway of Controlled Rehabilitation With Early Ambulation and Diet and Traditional Postoperative Care After Laparotomy and Intestinal Resection
Abstract INTRODUCTION : In an era of dwindling hospital re sources and increasing medical costs , safe reduction in postoperative stay has become a major focus to optimize utilization of healthcare re sources . Although several protocol s have been reported to reduce postoperative stay , no Level I evidence exists for their use in routine clinical practice . METHODS : Sixty-four patients undergoing laparotomy and intestinal or rectal resection  were r and omly assigned to a pathway of controlled rehabilitation with early ambulation and diet or to traditional postoperative care .  Time to discharge from hospital , complication and readmission rates , pain level , quality of life , and patient satisfaction scores were determined at the time of discharge and at 10 and 30 days after surgery . Subgroups were defined to evaluate those who derived the optimal benefit from the protocol . RESULTS : Pathway patients spent less total time in the hospital after surgery ( 5.4 vs. 7.1 days ; P = 0.02 ) and less time in the hospital during the primary admission than traditional patients . Patients younger than 70 years old had greater benefits than the overall study group ( 5 vs. 7.1 days ; P = 0.01 ) . Patients treated by surgeons with the most experience with the pathway spent significantly less time in the hospital than did those whose surgeons were less experienced with the pathway ( P = 0.01 ) . There was no difference between pathway and traditional patients for readmission or complication rates , pain score , quality of life after surgery , or overall satisfaction with the hospital stay . CONCLUSIONS : Patients scheduled for a laparotomy and major intestinal or rectal resection  are suitable for management by a pathway of controlled rehabilitation with early ambulation and diet . Pathway patients have a shorter hospital stay , with no adverse effect on patient satisfaction , pain scores , or complication rates . Patients younger than 70 years of age derive the optimal benefit , and increased surgeon experience improves outcome
Other outcome parameters were unsuitable for meta- analysis , but seemed to favour ERAS .
Analysis shows a reduction in overall complications , but major complications were not reduced .
Length of stay was reduced significantly .
We state that ERAS seems safe , but the quality of trials and lack of sufficient other outcome parameters do not justify implementation of ERAS as the st and ard of care .
Within ERAS protocol s included , no answer regarding the role for minimally invasive surgery ( i.e. laparoscopy ) was found .
BACKGROUND In recent years the Enhanced Recovery after Surgery ( ERAS ) postoperative pathway in (ileo-)colorectal surgery , aim ing at improving perioperative care and decreasing postoperative complications , has become more common .
OBJECTIVES We investigated the effectiveness and safety of the ERAS multimodal strategy , compared to conventional care after (ileo-)colorectal surgery .
The primary research question was whether ERAS protocol s lead to less morbidity and secondary whether length of stay was reduced .