A Program for Improving Postoperative Recovery in Elective Colon Surgeries

Abstract

Introduction: Enhanced recovery after surgery (ERAS) programs are a set of actions applied to the surgical patient in the perioperative period, focusing on reducing the impact of surgery on the metabolic and endocrine response, with the aim of achieving an earlier recovery of higher quality.

Objective: To evaluate the results of the application of the enhanced recovery protocol after surgery in elective major surgical procedures of the colon.

Methods: A descriptive, longitudinal and prospective study was conducted with 163 patients indicated for elective major surgery of the colon at Hospital Clínico Quirúrgico “Hermanos Ameijeiras”, during the period 2017-2020, and who were applied the implemented ERAS program.

Results: The mean age of the patients was 65.4 ± 13.2 years, with a predominance of the female sex (57.7 %). 78.5 the patients tolerated a soft diet and expelled gases or faces througth the rectum at two days after the operation. The average postoperative stay was 4.9 ± 3.4 days and, in patients without complications, it was reduced to 4.0 ± 1.0 days. Reported mortality was 3.1 % (five cases). Complications occurred in 20.2 % of the patients. 6.7 % of patients required readmission during the first thirty days.

Conclusions: The implementation of a program for improving postoperative recovery of patients with elective interventions of the colon shows satisfactory results and improves the historical results of Hospital Clínico Quirúrgico “Hermanos Ameijeiras” in terms of complications, length of stay and mortality.

Keywords: colon surgery; early postoperative complication; ERAS program.