Conventional versus enhanced recovery after surgery protocols in emergency gastrointestinal tract surgery: a randomized clinical trial

• Published in: The Egyptian journal of surgery : official organ of the Egyptian Society of Surgeons = Majallat al-jirāhah al-Misrīyah 2024-01, Vol.43 (1), p.330-336
• Main Authors: Rida, Ramy R., Abdallah, Abdallah B., Helmy, Ashraf A., A. A., Abdelmotaleb
• Format: Article
• Language: English
• Subjects: Original article
• ISSN: 1110-1121; 1687-7624
• DOI: 10.4103/ejs.ejs_221_23

Background Compared with elective operations, emergency abdominal surgery is more likely to result in perioperative morbidity and mortality. Implementation of care programs could be beneficial for such patients to decrease complication rates. Enhanced recovery after surgery (ERAS) is a complex perioperative approach that has proven its efficacy in multiple elective procedures. Nonetheless, its efficacy in emergency abdominal surgery has been questioned. Herein, we compared the ERAS and conventional approaches in the management of such patients. Patients and methods Sixty adult patients were enrolled in our randomized prospective trial, and they were assigned to two groups; the conventional and ERAS groups. The duration of hospitalization was the main outcome. Results Preoperative characteristics, presentation, and surgical operations were comparable between the two study groups. A perforated duodenal ulcer was the most common diagnosis and was treated by through and through suture with the omental patch (36%) followed by resection anastomosis (36%) in patients with ischemic loop or patients with severely injured loops, and primary repair in simple injury (28%). The hospitalization period decreased significantly in ERAS patients (5.9 vs. 10.5 days in the conventional group P