Comparative Study of Conventional Care Vs. Enhanced Recovery After Surgery (ERAS) in Colorectal Surgery : a...

Enhanced Recovery After Surgery (ERAS) protocols aim to reduce surgical stress, postoperative morbidity, and length of hospital stay following colorectal surgery. While ERAS has been widely adopted in high-income countries, evidence from low- and middle-income tertiary care settings remains limited. This study compares perioperative outcomes of ERAS versus conventional care in patients undergoing colorectal cancer surgery.

This retrospective observational study analyzed a prospectively maintained database of 153 patients who underwent elective colorectal cancer resections at a tertiary oncology center between July 2023 and July 2025. Patients were divided into a pre-ERAS group (Group I, n = 85) and a post-ERAS group (Group II, n = 68). Primary endpoints included length of hospital stay, postoperative complications, protocol compliance, and 30-day readmissions. Secondary outcomes assessed specific complication categories. Descriptive and comparative statistical analyses were performed.

Baseline demographic, clinical, and tumor characteristics were comparable between groups. Implementation of ERAS resulted in a significant reduction in median length of hospital stay from 7.8 to 5.6 days (28.2% reduction). Overall ERAS compliance improved markedly from 32.5% in the pre-ERAS period to 86.0% post-implementation, with substantial gains across preoperative, intraoperative, and postoperative components. Major postoperative complications, including anastomotic leak and surgical site infections, remained low and comparable between groups. Pulmonary outcomes improved, and no increase in cardiovascular complications was observed. Gastrointestinal complications such as postoperative ileus and nausea were more frequent in the post-ERAS group but did not translate into increased morbidity or readmission rates.

Implementation of ERAS protocols in colorectal cancer surgery is feasible and safe in a tertiary care setting and is associated with significantly reduced hospital stay and improved protocol adherence without increasing major postoperative morbidity. High compliance with ERAS pathways plays a crucial role in optimizing short-term surgical outcomes.