Our experience of using the ERAS program in surgical interventions in patients with dolichomegacolon

Abstract

Introduction The ERAS program is a multicomponent system of activ- ities carried out in the pre-, intra- and postoperative pe- riod, aimed at reducing the incidence of postoperative complications, accelerating the recovery of normal activ- ity of patients and reducing the length of stay of patients in the hospital. Despite the proven benefits, the ERAS program is still underused in practice. Its implementation requires a whole range of organizational measures. Purpose of the study: To evaluate the effectiveness of the ERAS program after surgery for dolichomegacolon. Material and methods 233 surgical interventions were performed in patients with dolichomegacolon in a planned manner at the surgi- cal clinic of the AMU. The age of the patients varied from 7 to 26 years. Surgical interventions were performed both laparoscopically and traditionally. The patients were di- vided into 2 groups: main (n=130) and control (n=103). In the control group, the perioperative period in patients was conducted traditionally. In the main group, the peri- operative period was managed using elements of the gen- erated optimized ERAS protocol. Results In the main group, the absolute majority of patients started enteral nutrition within the first 6 hours of the postoperative period. Against this background, their pro- tein pool was restored already by the 4th day of the post- operative period, while in the control group not earlier than the 9th day (p<0.05), which coincides with the liter- ature data. In the main group, the frequency of prescrib- ing narcotic analgesics also decreased, as they were used only in 23.5% of patients, while in the control group, opi- oids were prescribed after surgery in 95.7% of patients (p<0.05). In the main group of patients, there were no cases of thromboembolic complications in any patient, and postoperative nausea and vomiting were observed only in 1.2% of patients. Conclusion The use of the ERAS program for surgical interventions on the large intestine helps to reduce the body's response to operational stress, reduces the time required for the pa- tient's rehabilitation, and reduces the risk of postoperative complications.

Keywords

• dolichomegacolon
• enhanced recovery after surgery