A Colorectal Unit with an Enhanced Recovery After Surgery (ERAS) Programme Improves Surgical Outcomes in a Major Metropolitan Hospital

Abstract

Objectives: We aimed to assess the surgical outcomes associated with the introduction of a dedicated colorectal service and newlyimplemented enhanced recovery after surgery (ERAS) programme at Logan Hospital.Methods: A prospective database was created to include all patients admitted to Logan hospital for colorectal resections after theestablishment of a dedicated colorectal service with two colorectal surgical society of Australia and New Zealand (CSSANZ) trainedcolorectal surgeons and an ERAS programme. The demographics, pathology and surgical outcomes in this patient group were comparedto a historical retrospective patient cohort from the same hospital with resections performed by general surgeons prior tothe introduction of the ERAS programme. Primary outcomes included the length of stay, readmission rate, morbidity and mortality.Results: The prospective database included patients from February to November 2015 with a minimum 30 day follow-up (n = 72).The retrospective patient cohort was from January to December 2012 (n = 68). The average length of stay (LOS) reduced from 10.85days to 5.74 days (P = 0.037). Thirty day readmission rates decreased from 7.35% to 4.17% (P = 0.485). Morbidity reduced from 41.18% to11.11% (P < 0.001). Mortality rates of 2.94% pre ERAS and nil post (P = 0.234). Demographic information, co-morbidities and pathologywere comparable.Conclusions: Our results suggest that a dedicated colorectal service with an ERAS program is able to improve surgical outcomesincluding length of stay, morbidity and mortality. This is in keeping with existing international literature.

Keywords

• eras
• colorectal