Ibrahim, A., Moustafa, R., Moustafa, A., EL-Rabaa, S., Salama, Y. (2018). Enhanced Recovery Program (ERP) versus Traditional care after Elective Left Side Colorectal Cancer Surgery. The Egyptian Journal of Hospital Medicine, 72(8), 5122-5129. doi: 10.21608/ejhm.2018.10582
Ahmad Aboelkassem Ibrahim; Reda M. Moustafa; Ashraf Abdulmoghni Moustafa; Saleem EL-Rabaa; Yahya Salama. "Enhanced Recovery Program (ERP) versus Traditional care after Elective Left Side Colorectal Cancer Surgery". The Egyptian Journal of Hospital Medicine, 72, 8, 2018, 5122-5129. doi: 10.21608/ejhm.2018.10582
Ibrahim, A., Moustafa, R., Moustafa, A., EL-Rabaa, S., Salama, Y. (2018). 'Enhanced Recovery Program (ERP) versus Traditional care after Elective Left Side Colorectal Cancer Surgery', The Egyptian Journal of Hospital Medicine, 72(8), pp. 5122-5129. doi: 10.21608/ejhm.2018.10582
Ibrahim, A., Moustafa, R., Moustafa, A., EL-Rabaa, S., Salama, Y. Enhanced Recovery Program (ERP) versus Traditional care after Elective Left Side Colorectal Cancer Surgery. The Egyptian Journal of Hospital Medicine, 2018; 72(8): 5122-5129. doi: 10.21608/ejhm.2018.10582
Enhanced Recovery Program (ERP) versus Traditional care after Elective Left Side Colorectal Cancer Surgery
1Colorectal Department, Kettering General Hospital – United Kingdom
2Department of General Surgery, Faculty of Medicine – Ain Shams University – Egypt
Abstract
Aims: We aimed to study the effect of ERAS protocol after left side colorectal cancer surgery in comparison with patients were subjected to traditional care. Methods: Retrospective study comparing 2 groups of patients who underwent elective left side colorectal cancer surgery. Group A: 25 patients admitted between November 2014 and April 2015 subjected to ERAS, and Group B: 25 patients admitted between January 2008 and August 2008 received traditional care. Both groups were consecutive cases. The notes were examined to determine the following outcome measures: Short-term morbidity, Length of stay, 30 days Readmission rate and Mortality. Results: 25 patients with ERAS matched with 25 traditional recovery cases for baseline demographics. 96% started oral fluids on D1 in group A compared to 8% in group B, 96% in group . A tolerated full diet on D6 compared to 72% in group B. Bowel movements by D5 was group A 92% compared to only 36% in group B. Total LOS mean for group A was 7 days vs 12.48 in group B (p=0.005). Complications occurred less frequently in group A compared to group B (anastomotic leak with 8% (n=2) in group A versus 16% (n=4) in group B, prolonged ileus with 8% (n=2) in group A versus 16% (n=4) in group B (p = 0.663). Mobility on D1 40% (n=10) in group A was an independent factor which decreased LOS, as all stayed< 5 days (p=0.002) and developed less complications (4% (p=0.027)). Conclusion: ERAS didn’t affect complications rate significantly following left side colorectal surgery, however reduced LOS as it improved tolerating oral intake and bowel movement. Mobility D1 can be independent pridector of reduced both complications and LOS and should be encouraged for all patients.
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