Enhanced Recovery After Surgery: Can We Rely on the Key Factors or Do We Need the Bel Ensemble?

Enhanced Recovery After Surgery: Can We Rely on the Key Factors or Do We Need the Bel Ensemble?

Jurt J, Slieker J, Frauche P, Addor V, Solà J, Demartines N, Hübner M (2017)Enhanced Recovery After Surgery: Can We Rely on the Key Factors or Do We Need the Bel Ensemble? World J Surg. 2017 Oct;41(10):2464-2470. 

What is already known:

Lots of studies have shown that the higher the compliance with the ERAS elements the better the outcomes (both long and short; however, a lot of institutions find it difficult to adhere to all elements. This paper aims to assess the impact of each element to outcomes.

What this paper adds:

Minimally invasive surgery in this study was associated with reduced complications. However, the use of NG tubes, prophylactic abdominal / pelvic drains, thoracic epidurals and a high ASA score were all independent risk factors for complications. Like other papers looking at adherence, they found that with increasing adherence the better the outcomes and lower the complications. The threshold for adherence with the elements was 70%, below which complications rose and length of hospital stay increased.

Chris Jones, Guildford. @chrisnjones