Natalia Gajewska, Grzegorz Torbicz, Magdalena Mizera, Jan Witowski, Magdalena Pisarska, MD, Mateusz Rubinkiewicz, MD, PhD, Piotr Major, MD, PhD, Michal Pedziwiatr, MD, PhD. 2nd Department of General Surgery, Jagiellonian University Medical College, Cracow, Poland
Introduction: Better adherence to ERAS is associated with improved short-term outcomes and increased long-term survival. Enhanced recovery after surgery (ERAS) pathways have proven to enhance postoperative recovery and reduce postoperative morbidity and length of hospital stay after colorectal cancer surgery. However, despite the benefits of the ERAS program in short-term results, little is known about its impact on long-term results.
Material and Methods: Between the years 2013 and 2015, 335 patients underwent laparoscopic colorectal cancer resection in 2nd Department of General Surgery Jagiellonian University Medical College. Patients were divided into two groups according to their degree of adherence to the ERAS interventions: group 1 – <80% (103 patients) and group 2 – ≥80% (232 patients). The relation between the rate of compliance to the ERAS protocol and 3-year survival was analysed according to the Kaplan–Meier method with Log-rank test.
Results: The groups were similar in terms of demographics and surgical parameters. The median compliance to ERAS interventions was 85%. Our analysis revealed, that adherence to the ERAS protocol in the group 2 with ≥80% adherence was associated with significantly shorter length of hospital stay (6 vs 4 days, p<0.0001), lower rate of postoperative complications (44.7% vs. 23.3%, p<0.0001) and improved in functional recovery parameters: tolerance of oral diet (53.4% vs. 81.5%, p<0.0001) and mobilization (77.7% vs. 96.1%, p<0.0001) on the first postoperative day. Increased adherence to the ERAS protocols (group 2) was associated with significantly improved long-term overall survival compared with patients with lower adherence (group 1) (p<0.0007). 3-year overall survival was 89% and 76% in group 1 and 2, respectively.
Conclusion: High adherence to the ERAS protocol improve short-term outcomes such as length of hospitalization, morbidity, recovery parameters, as well as long-term survival after laparoscopic colorectal cancer surgery.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94137
Program Number: P336
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster