Skip to main content

Advertisement

Log in

Safety and Feasibility of Enhanced Recovery after Surgery (ERAS) Protocol in Patients Undergoing Stoma Closure

  • Original Article
  • Published:
Indian Journal of Surgery Aims and scope Submit manuscript

Abstract

Enhanced Recovery after Surgery (ERAS) protocol is a multimodal approach which includes variety of pre-, intra-, and postoperative components to minimize surgical trauma, reduce complications, and decrease hospital length of stay, while expediting accelerated recovery following elective procedures. This study aimed to compare the postoperative outcome using the conventional management versus ERAS protocol in patients undergoing stoma (ileostomy and colostomy) closure. A prospective, comparative, longitudinal study was conducted using census technique in 30 patients admitted to surgery department, between January 2018 and March 2019 for ileostomy or colostomy closure. The postoperative length of hospital stay, readmission, morbidity, and mortality were compared between two groups of participants undergoing stoma closure either by ERAS (group A, n = 15) or by conventional care (group B, n = 15) protocol. Chi-square test and Student t test were used for analysis. The mean postoperative length of hospital stay was shorter in ERAS group compared with conventional care group (1.5 vs. 6.5 days, p < 0.001). However, no statistically significant differences were reported in terms of readmission and morbidity between the two groups. One major morbidity (anastomotic leak) in conventional group was reported. There was no 30-day mortality in either group. In comparison with the conventional care group, the application of ERAS protocol in the stoma closure resulted in decreased postoperative length of hospital stay. No differences were observed for readmission, re-exploration, and other postoperative morbidities between the two groups.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kehlet H, Wilmore DW (2008) Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 248:189–198

    Article  Google Scholar 

  2. Ljungqvist O, Scott M, Fearon KC (2017) Enhanced recovery after surgery a review. JAMA Surg 152:292–298

    Article  Google Scholar 

  3. Pine, J. & Stevenson, L. Intestinal stomas (2017) Surg. (United Kingdom) 35, 165–170

  4. Zargar-Shoshtari K, Hill AG (2008) Optimization of perioperative care for colonic surgery: a review of the evidence. ANZ J Surg 78:13–23

    Article  Google Scholar 

  5. Henriksen MG, Hansen HV, Hessov I (2002) Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization. Nutrition 18:263–267

    Article  Google Scholar 

  6. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  Google Scholar 

  7. Slieker JC, Clerc D, Hahnloser D, Demartines N, Hübner M (2017) Prospective evaluation of discharge trends after colorectal surgery within an enhanced recovery after surgery pathway. Dig Surg 34:298–304

    Article  Google Scholar 

  8. Kalady MF, Fields RC, Klein S, Nielson KC, Mantyh CR, Ludwig KA (2003) Loop ileostomy closure at an ambulatory surgery facility: a safe and cost-effective alternative to routine hospitalization. Dis Colon Rectum 46:486–490

    Article  Google Scholar 

  9. Pirzada MT, Naseer F, Haider R et al (2017) Enhanced recovery after surgery (ERAS) protocol in stoma reversals. J Pak Med Assoc 67:1674–167\

    PubMed  Google Scholar 

  10. Berger NG, Chou R, Toy ES, Ludwig KA, Ridolfi TJ, Peterson CY (2017) Loop ileostomy closure as an overnight procedure: institutional comparison with the National Surgical Quality Improvement Project data set. Dis Colon Rectum 60:852–859

    Article  Google Scholar 

  11. Wind J, Polle SW, Fung Kon Jin PH et al (2006) Systematic review of enhanced recovery programmes in colonic surgery. Br J Surg 93:800–809

    Article  CAS  Google Scholar 

  12. Garfinkle R, Trabulsi N, Morin N et al (2017) Study protocol evaluating the use of bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicenter randomized controlled trial. Colorectal Disease 11(19):1024–1029

    Article  Google Scholar 

  13. Browning L, Denehy L, Scholes RL (2007) The quantity of early upright mobilisation performed following upper abdominal surgery is low: an observational study. Aust J Physiother 53:47–52

    Article  Google Scholar 

  14. Pavlin DJ, Chen C, Penaloza DA, Polissar NL, Buckley FP (2002) Pain as a factor complicating recovery and discharge after ambulatory surgery. Anesth Analg 95:627–634

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

The manuscript has been read and approved by all the authors, that the requirements for authorship as stated earlier in this document have been met, and that each author believes that the manuscript represents honest work.

Corresponding author

Correspondence to Narendra Pandit.

Ethics declarations

The study protocol was approved by the Institutional review board, and informed consent was obtained from each patient for the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kurmi, S., Pandit, N., Sah, S. et al. Safety and Feasibility of Enhanced Recovery after Surgery (ERAS) Protocol in Patients Undergoing Stoma Closure. Indian J Surg 83, 703–707 (2021). https://doi.org/10.1007/s12262-020-02320-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12262-020-02320-w

Keywords

Navigation