Effects of an Enhanced Recovery After Surgery programme on emergency surgical patients.

ERAS in Emergency Surgery

Effects of an Enhanced Recovery After Surgery programme on emergency surgical patients.

Effects of an Enhanced Recovery After Surgery programme on emergency surgical patients (2016) Wisely JC, Barclay KL. ANZ J Surg. 2016 Nov;86(11):883-888.

What is already known:
The majority of ERAS research has been focussed, quite rightly, on improving outcomes in elective surgery. However emergency surgery has high rates of morbidity and mortality and a lot more interest more recently has been directed at how ERAS elements could affect outcomes in this high-risk group.

What this paper adds:
In this retrospective review the authors compared 2 groups of patients undergoing emergency major abdominal surgery before and after an ERAS program had been introduced for their elective colorectal surgery patients. A total of 370 patients were included. The two groups were similar in age, co-morbidities and ASA scores. The post-ERAS group underwent significantly more left sided procedures. Hospital length of stay was similar in both groups [median 8 days], but the post-ERAS group received significantly less intravenous fluid, both intra-operatively and post-operatively. Significantly fewer patients in the post-ERAS group had a urinary catheter or PCA for more than 2 days. There were also fewer abdominal drains used in the post-ERAS group. This resulted in significantly reduced major post-operative complications in particular chest infections. Suggesting that ERAS elements could have a place in both elective and emergency surgery.

Chris Jones, Guildford.