Outcome of Enhanced Recovery After Surgery (ERAS) Protocols in Patients Undergoing Small Bowel Surgery
Condition: Enhanced Recovery After Surgery
Study type: Observational [Patient Registry]

Summary: 
      It was a descriptive case series conducted it Department of Surgery, Services Hospital,
      Lahore. Total of 140 patients who underwent small bowel resection anastomosis were subjected
      to ERAS protocols.The objective of this study was to determine the outcome of applying
      enhanced recovery after surgery (ERAS) protocols in patients undergoing small bowel surgery.
    

Detailed description: 
      It was a descriptive case series study conducted at Surgical Unit II, Services Hospital,
      Lahore. Sample size of 140 cases was calculated with 95% confidence level, 4.5% margin of
      error while taking expected percentage of anastomotic leakage in 8% cases passed through
      Enhanced Recovery after Surgery protocole.9 Patients were selected by Non-probability
      Purposive Sampling. Patients of both sex groups with ages between 20-45 years. Having
      elective surgery of small bowel resection and anastomosis admitted through OPD were included
      in the study. Patient with co-morbid conditions falling in ASA Class III or greater and
      patients with metastatic tumours of small bowel were excluded from the study. 140 patients
      presenting in the surgical outdoor of Services Hospital, Lahore who fulfilled the inclusion
      criteria were included in the study. A detailed history was taken including demographic data
      (age, gender and address). Patients were requested to sign an informed consent after
      explaining them the details of the study. ERAS protocols were implemented. Patients were
      followed after 4 weeks post-operatively in outdoor and outcome were measured in terms of
      length of hospital stay, post-operative wound infection, anastomotic leakage and death. All
      the surgeries and the follow ups were performed by the consultant in charge of the unit to
      eliminate bias. Confounding variables were controlled by exclusion. All the data was recorded
      into the attached proforma.(annexed). All the collected data was entered into SPSS version
      10. Numerical variables like age and length of hospital stay have been presented by mean ±SD.
      Categorical variables i-e gender, post-operative wound infection, anastomotic leakage and
      mortality have been presented by frequency and percentage. Data has been stratified for
      anastomotic leakage to deal with effect modifier. Chi square test has been applied post
      stratification with P-value ≤0.05 taken as significant.
    

Intervention name(s): Enhanced recovery after surgery
Intervention type(s): Other
Intervention description(s): Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways designed to achieve early recovery after surgical procedures by maintaining preoperative organ function and reducing the profound stress response after surgery. It benefits patient by reducing complications and enhancing recovery and saves resources for the health care system. In this concept, surgeons work collaboratively with anesthesiologist, nurses, nutritionists and physical therapists to develop and manage the perioperative care.
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Sample size of 140 cases was calculated with 95% confidence level, 4.5% margin of error
        while taking expected percentage of anastomotic leakage in 8% cases passed through Enhanced
        Recovery after Surgery protocole.