The influence of the implementation of ERAS recommendations on the results in patients in colorectal surgery: a retrospective and comparative study
Authors:
J. Richtarová 1,2; I. Satinský 2,3
; P. Schwarz 2; T. Skoblej 2; E. Mrázková 1,4,5
Authors place of work:
Ústav epidemiologie a ochrany veřejného zdraví Lékařská fakulta, Ostravská univerzita v Ostravě Vedoucí ústavu: doc. MUDr. Rastislav Maďar, Ph. D., MBA, FRCPS
1; Mezioborová jednotka intenzivní péče Nemocnice Havířov Primář: MUDr. Igor Satinský, Ph. D.
2; Ústav nelékařských zdravotnických studií Fakulta veřejných politik, Slezská univerzita v Opavě Vedoucí ústavu: PhDr. Zdeňka Římovská, Ph. D.
3; Oddělení ORL Nemocnice s poliklinikou Havířov Primář: MUDr. Eva Mrázková, Ph. D.
4; Centrum pro poruchy sluchu a rovnováhy, Ostrava
5
Published in the journal:
Prakt. Lék. 2022; 102(3): 125-139
Category:
Of different specialties
Summary
Introduction: The aim of this study was a comparison of postoperative care with selected elements of the ERAS (Enhanced Recovery After Surgery) protocol: optimal analgesia, non-aggressive fluid replacement, nausea and vomiting prevention, early oral or enteral intake, early removal of drains, nasogastric tubes and permanent urinary catheters, early rehabilitation.
Patients and methods: Data were obtained based on established criteria from the medical documentation of a selected group of patients after planned intestinal resections, with a stay in the intensive care unit (ICU) of at least 48 hours. The research group was composed of patients hospitalised in two surgical ICUs. Seventy-nine patients were included in the study at the medical facility in Karviná (ICU 1), and one hundred and seven patients were enrolled in Havířov (ICU 2).
Results: Based on a retrospective analysis of the information obtained, it is evident that specific partial procedures from the ERAS protocol were implemented at both ICU workplaces. A statistically significant difference was found in the optimal postoperative analgesia (epidural catheter) and adherence to fluid restriction up to 2.5 litres. Furthermore, statistically significant differences in srovthe frequency of laparoscopies, early oral and enteral intake, early removal of drains, nasogastric tubes and permanent urinary catheters were noted.
Conclusion: The level of ERAS implementation in the monitored workplaces differs in individual steps, but these differences did not lead to different results in the mentioned study. It is demonstrably impossible to determine which elements of the ERAS concept significantly affect the final results.
Keywords:
surgery – postoperative complications – perioperative care – Enhanced Recovery After Surgery – fast-track surgery – length of hospital stay
Zdroje
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