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 .
A fast-track program reduces complications and length of hospital stay after open colonic surgery.
BACKGROUND & AIMS A fast-track program is a multimodal approach for patients undergoing colonic surgery that combines stringent regimens of perioperative care ( fluid restriction , optimized analgesia , forced mobilization , and early oral feeding ) to reduce perioperative morbidity , hospital stay , and cost . We investigated the impact of a fast-track protocol on postoperative morbidity in patients after open colonic surgery . METHODS A r and omized trial of patients in 4 teaching hospitals in Switzerl and included 156 patients undergoing elective open colonic surgery who were assigned to either a fast-track program or st and ard care . The primary end point was the 30-day complication rate . Secondary end points were severity of complications , hospital stay , and compliance with the fast-track protocol . RESULTS The fast-track protocol significantly decreased the number of complications ( 16 of 76 in the fast-track group vs 37 of 75 in the st and ard care group ; P = .0014 ) , result ing in shorter hospital stays ( median , 5 days ; range , 2 - 30 vs 9 days , respectively ; range , 6 - 30 ; P < .0001 ) . There was a trend toward less severe complications in the fast-track group . A multiple logistic regression analysis revealed fluid administration greater than the restriction limits ( odds ratio , 4.198 ; 95 % confidence interval , 1.7 - 10.366 ; P = .002 ) and a nonfunctioning epidural analgesia ( odds ratio , 3.365 ; 95 % confidence interval , 1.367 - 8.283 ; P = .008 ) as independent predictors of postoperative complications . CONCLUSIONS The fast-track program reduces the rate of postoperative complications and length of hospital stay and should be considered as st and ard care . Fluid restriction and an effective epidural analgesia are the key factors that determine outcome of the fast-track program
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 .