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Updated: May 28, 2025

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Enhanced Recovery Independently Lowers Failure to Rescue After Colorectal Surgery.

Marco Catarci1, Giacomo Ruffo2, Massimo Giuseppe Viola3

  • 1General Surgery Unit, Sandro Pertini Hospital, ASL Roma 2, Roma, Italy.

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|February 11, 2025
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Summary
This summary is machine-generated.

High adherence to the enhanced recovery after surgery (ERAS) pathway significantly reduces failure to rescue rates in patients undergoing elective colorectal surgery. Achieving over 70% adherence independently lowers these critical outcomes.

Keywords:
Colorectal surgeryEnhanced recovery after surgeryFailure to rescue

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Area of Science:

  • Colorectal Surgery
  • Surgical Outcomes
  • Patient Recovery Pathways

Background:

  • Enhanced recovery after surgery (ERAS) pathways are known to reduce morbidity and mortality.
  • Optimizing adherence to ERAS protocols is crucial for improving surgical outcomes.

Purpose of the Study:

  • To investigate the impact of adherence to the ERAS pathway on failure to rescue (FTR) rates.
  • To identify factors influencing FTR after elective colorectal surgery.

Main Methods:

  • Retrospective analysis of a prospective database from 78 Italian centers (2019-2021).
  • Included adult patients undergoing elective colorectal resection for benign or malignant disease.
  • FTR defined as deaths divided by adverse events; logistic regression identified predictors.

Main Results:

  • Adverse events occurred in 27.8% of 8359 patients; major adverse events in 6.3%; death in 1.0%.
  • FTR rates were 3.8% (any adverse event) and 16.8% (major adverse event).
  • Adherence to ERAS pathway >70% independently reduced FTR rates.

Conclusions:

  • High adherence (>70%) to the ERAS pathway is an independent protective factor against failure to rescue.
  • Patient-related (age, ASA class, nutrition) and treatment-related factors (resection type, anastomotic leakage, reoperation) also predict outcomes.