Impact of the compliance to fast recovery programs on colorectal surgery (ERAS) in clinical outcomes: experience in referenced public hospital in colorectal cancer

• Grant number: 19/16052-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): November 01, 2019
• Effective date (End): October 31, 2020
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Sergio Eduardo Alonso Araujo
• Grantee: Maria Luiza Vianna Olive
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil

Abstract

The ERAS (Enhanced Recovery After Surgery) protocol was initially described in 2001 with the intention of improving perioperative care. At that time, some measures intended for this type of care were already applied, being called "fast-track surgery" (surgeries of fast recovery). This term was questioned by some because it gave the idea that an improvement in care would lead only to a shorter hospitalization time, without considering other aspects that would benefit the recovery of the patient in general. The ERAS protocol defies traditional methods of perioperative care and proposes alternatives based on clinical evidence to improve patient care. It involves a multidisciplinary team (nurses, nutritionists, physiotherapists, clinicians, anesthesiologists and surgeons) and includes a series of measures that, when isolated, may result in a significant improvement in outcomes related to postoperative recovery, but together, can improve these parameters and reduce complications. The protocol was built with the objective of being multimodal, therefore, all the measures proposed must be applied in order to improve the recovery of the patient. It padronizes its guidelines and elements that, when applied, result in reduced levels of morbidity, faster recovery and shorter hospital stay. Today, the principles of ERAS, initially developed for colorectal resections, are being used in other specialties, and there is a continuous update of care protocols as the study area expands.The Service of Colorectal Cancer Surgery at the Hospital Municipal Vila Santa Catarina, in São Paulo, implemented the ERAS protocol for approximately three years, being one of the first Hospitals in Brazil to include this strategy in its routine. The present study analyzes the outcomes resulting from the application of the protocol in patients submitted to colorectal surgery at this Hospital.