Eight years of experience with Enhanced Recovery After Surgery in patients with colon cancer: Impact of measures to improve adherence

Background Perioperative treatment of patients with colorectal cancer according to the Enhanced Recovery After Surgery (ERAS) protocol has proven to reduce complications and duration of stay. However, strict adherence remains a challenge and the benefits may decrease with lower adherence. In this st...

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Bibliographic Details
Published in:Surgery 2015-06, Vol.157 (6), p.1130-1136
Main Authors: Bakker, Nathalie, MD, Cakir, Hamit, MD, Doodeman, H.J., MSc, Houdijk, A.P.J., MD, PhD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis of Variance
Cohort Studies
Colectomy - methods
Colonic Neoplasms - pathology
Colonic Neoplasms - surgery
Colonic Neoplasms - therapy
Confidence Intervals
Elective Surgical Procedures - methods
Female
Follow-Up Studies
Guideline Adherence - statistics & numerical data
Humans
Male
Middle Aged
Monitoring, Physiologic - standards
Multivariate Analysis
Netherlands
Patient Compliance - statistics & numerical data
Perioperative Care - standards
Practice Guidelines as Topic
Recovery of Function
Retrospective Studies
Risk Assessment
Surgery
Time Factors
Treatment Outcome
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Summary:Background Perioperative treatment of patients with colorectal cancer according to the Enhanced Recovery After Surgery (ERAS) protocol has proven to reduce complications and duration of stay. However, strict adherence remains a challenge and the benefits may decrease with lower adherence. In this study, we report on 8 years of adherence to the ERAS protocol and its effect on postoperative outcome in patients with colon cancer. Methods In 2006, the ERAS protocol was introduced for treatment of colon cancer patients in the Medical Center Alkmaar, a large teaching hospital. Patients scheduled for elective colon cancer resection were included in this study. Adherence to ERAS items was monitored and along with clinical data prospectively gathered in a database. In 2011, several measures to improve adherence were implemented. Results In total, 816 patients were included. Mean adherence rate was 73% in 2006 and 2007, 66% in 2008 and 2009, 63% in 2010 and 2011, and 82% in 2012 and 2013. There was a shorter duration of stay in the years with high adherence (5.7 days) compared with the years with low adherence (7.3 days; P  
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2015.01.016