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 newly implemented 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 the establishment of a dedicated colorectal service with two colorectal surgical society of Australia and New Zealand (CSSANZ) trained colorectalsurgeonsandanERASprogramme. Thedemographics,pathologyandsurgicaloutcomesinthispatientgroupwerecom-pared to a historical retrospective patient cohort from the same hospital with resections performed by general surgeons prior to theintroductionof theERASprogramme. Primaryoutcomesincludedthelengthof stay,readmissionrate,morbidityandmortality. 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 10.85 daysto5.74days(P=0.037). Thirtydayreadmissionratesdecreasedfrom7.35% to4.17% (P=0.485). Morbidityreducedfrom41.18% to 11.11% (P< 0.001). Mortalityratesof 2.94% preERASandnilpost(P=0.234). Demographicinformation,co-morbiditiesandpathology were comparable. Conclusions: Our results suggest that a dedicated colorectal service with an ERAS program is able to improve surgical outcomes including length of stay, morbidity and mortality. This is in keeping with existing international literature.