IMPLEMENTATION OF ENHANCED RECOVERY AFTER COLORECTAL SURGERY (ERAS) PROTOCOL: INITIAL RESULTS OF THE FIRST BRAZILIAN EXPERIENCE

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posted on 2019-02-13, 02:47 authored by Uirá Fernandes TEIXEIRA, Paulo Roberto Ott FONTES, Cristiane Weckerle Nazareth CONCEIÇÃO, Carlos Alberto Teixeira FARIAS, Daieni FERNANDES, Ingrid Petroni EWALD, Luciano VITOLA, Florentino Fernandes MENDES

ABSTRACT Background: Guidelines for enhanced recovery after surgery have their bases in colonic surgery, through the first protocols published in 2012. Since then, this practice has spread throughout the world, mainly due to improvements in surgical outcomes associated with resource savings. Aim: To analyze the first prospective results after the implementation of the guidelines. Methods: Were retrospectively analyzed 48 patients operated in the institution prior to the standardization. This group was then compared with a series of 25 patients operated consecutively after the guidelines were implemented. Results: With a 68.6% compliance rate, hospital length of stay (p=0.002), use of abdominal drains (p<0.001) and mechanical bowel preparation (p<0.001) were reduced. Mortality rates, anastomotic fistula, abdominal abscesses and reoperations were also reduced, but without statistical significance. Conclusion: Enhanced recovery after surgery protocols benefit patients care, resulting in better outcomes and possibly resource savings. Even with some limitations, its implementation is feasible in the Brazilian Public Health System.