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Accelerated 23-h enhanced recovery protocol for colon surgery: the CHASE-study
Thaís T T Tweed1, Misha A T Sier2, Imane Daher2
1Department of Gastrointestinal Surgery, Zuyderland Medical Center, Dr. H. van der Hoffplein 1, 6162 BG, Sittard-Geleen, The Netherlands. th.tweed@zuyderland.nl.
Scientific Reports
|December 1, 2022
Summary
An accelerated 23-hour Enhanced Recovery After Surgery (ERAS) protocol, the CHASE-protocol, demonstrated feasibility and safety in colorectal cancer patients. This approach significantly reduced length of stay while maintaining similar complication rates.
Area of Science:
- Colorectal Surgery
- Surgical Outcomes
- Enhanced Recovery Programs
Background:
- Enhanced Recovery After Surgery (ERAS) programs have improved postoperative outcomes in colorectal surgery.
- Optimizing ERAS to an accelerated recovery program may offer further benefits.
Purpose of the Study:
- To investigate the feasibility and safety of a 23-hour accelerated enhanced recovery protocol (ERP), the CHASE-protocol.
- To compare outcomes of the CHASE-protocol with standard ERAS care in colorectal cancer patients undergoing elective laparoscopic surgery.
Main Methods:
- A single-center, prospective study comparing the CHASE-protocol (23-hour ERP) with a retrospective cohort receiving standard ERAS care.
- Patients in the CHASE-cohort underwent elective laparoscopic colorectal cancer surgery (ASA I-II).
- Discharge occurred within 23 hours if criteria were met; primary outcome was successful discharge rate.
Main Results:
- Successful discharge within 23 hours was achieved in 80.5% of patients in the CHASE-cohort (33/41).
- The CHASE-cohort experienced a significantly shorter length of stay compared to the standard ERAS cohort.
- Readmission rates were higher in the CHASE-cohort, though overall complication rates were similar, with fewer severe complications.
Conclusions:
- The 23-hour accelerated ERP (CHASE-protocol) is feasible and safe for selected colorectal cancer patients.
- This accelerated protocol can significantly reduce hospital stay.
- Careful patient selection and adherence to discharge criteria are crucial for successful implementation.
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