ERAS in Laparoscopic Surgery for Colorectal Cancer: Risk Factors for Delayed Recovery

Study Overview
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Brief Summary
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Although there is evidence for reducing complication rate and improving recovery after the implementation of Enhanced Recovery After Surgery (ERAS) protocols into colorectal surgery, most published papers include patients undergoing open resections. The aim was to analyse factors affecting recovery and length of stay (LOS) in patients after laparoscopic colorectal surgery for cancer combined with ERAS protocol.

Detailed Description
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All patients were operated using laparoscopic surgery, and the perioperative care was based on pre-established ERAS protocol consisting of 13 pre and intraoperative items. Its principles and criteria for discharge from the hospital were based on the ERAS Society Guidelines. Investigators analysed which of the factors: gender; age; BMI; ASA (American Society of Anaesthesiologists) physical status; type of surgery (colonic resection vs. rectal resection with total mesorectal excision, TME); stage of cancer; distance between the hospital and place of residence; operative time; intraoperative blood loss significantly prolong LOS (primary length of stay, excluding readmissions). Moreover, the compliance with ERAS protocol and its influence on LOS was analysed. For the purposes of further analyses the entire group of patients was divided into 2 subgroups depending on the length of their hospital stay. On admission every patient received the information about the target length of stay of 4 days. Group 1 consisted of patients whose hospital stay was shorter or equal to the target LOS (≤ 4 days). In group 2 were patients whose hospital stay was longer than 4 days.

Official Title
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Enhanced Recovery After Surgery Protocol in Laparoscopic Surgery for Colorectal Cancer: Risk Factors for Delayed Recovery

Conditions
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Colonic Neoplasms, Laparoscopy, Perioperative Care

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: colorectal cancer laparoscopic resection perioperative care according to ERAS principles Exclusion Criteria: Patients submitted initially for open or emergency surgery with complex cancer who required multi-organ resection patients treated with endoscopic techniques using the hybrid TaTME technique (Transanal Total Mesorectal Excision)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group 1 (≤4 days)<br>Group 1 consisted of patients whose hospital stay was shorter or equal to the target LOS (≤ 4 days). | |
| Group 1 (>4 days)<br>In group 2 were patients whose hospital stay was longer than 4 days. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hospital length of stay (days) |  | participants will be followed for the duration of hospital stay, an expected average of 4 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Compliance with ERAS protocol (%) | Compliance (%) will be calculated as the number of pre and intraoperative interventions fulfilled/13*100% (number of pre- and intraoperative protocol elements included into compliance calculations) | participants will be followed for the duration of hospital stay, an expected average of 4 days | 
| Complication rate (%) |  | up to 30 days post surgery | 
| Readmission rate (%) |  | up to 30 days post surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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colorectal cancer, enhanced recovery after surgery, perioperative care, fast-track surgery, laparoscopy, minimally invasive surgery, complications