Outcome of Enhanced Recovery After Surgery Protocols in Patients Undergoing Small Bowel Surgery

Background and objective Enhanced recovery after surgery (ERAS) protocols are multimodal perioperative care pathways to help patients achieve early recovery after surgical procedures. However, no evidence could be found about its role in patients undergoing small bowel surgery. This study's objective was to determine the outcome of applying ERAS protocols in patients undergoing small bowel surgery. Materials and methods This study was a descriptive case series conducted in the Department of Surgery at Services Hospital in Lahore, Pakistan, from September 2017 to August 2019. One hundred forty patients who underwent small bowel resection anastomosis were subjected to ERAS protocols. Written informed consent was received from all patients. Results The mean age of the patients was 34.1 ± 7.1 years. There were 101 (72.1%) men and 39 (27.9%) women in the study sample. The mean length of postoperative hospital stay was 4.59 ± 1.69 days. Postoperative wound infection occurred in six (4.3%) patients, while anastomotic leakage was observed in 12 (8.6%) patients. Five (3.6%) patients died within 30 days of surgery. A significantly increased length of postoperative hospital stay was associated with anastomotic leakage (9.08 ± 1.975 vs. 4.16 ± 0.83 days; p=0.00). Similarly, the frequency of wound infection (41.7% vs. 0.8%; p=0.00) and 30-day patient mortality (41.7% vs. 0%; p=0.00) was also significantly higher among those patients who acquired anastomotic leakage. Conclusion ERAS protocols were associated with a significant reduction in length of hospital stay of the patients undergoing small bowel surgery without any significant increase is anastomotic leakage, wound infection or mortality. Furthermore, anastomotic leakage occurred in the patients was significantly associated with a longer hospital stay, wound infection, and 30-day mortality. Therefore, ERAS protocols can be safely applied to small bowel surgery.