Abstract 94P
Background
Enhanced Recovery After Surgery (ERAS) is becoming a popular strategy in colon cancer surgery, aiming to reduce surgery-related stress and improve patient recovery. Vietnam, a developing country with a specific health insurance system covering each surgery and hospital stay, has not yet promoted this program. We researched to evaluate its effectiveness.
Methods
The study includes 212 patients undergoing laparoscopic colectomy in central Vietnam from January 2021 to June 2024. Of these, 107 cases used traditional methods, while 105 were in the ERAS program. Primary outcomes were postoperative length of hospital stay (PLOS), time to first flatus and oral feeding, and postoperative short-term outcomes, including complications and the Clavien-Dindo classification.
Results
No significant differences in gender, BMI, surgical location, and complications between the two groups. Differences exist in stages 1 and 2 and the number of lymph nodes. The mean operative time of the ERAS group was 153±40 minutes, significantly shorter than the traditional group’s 170±29 minutes. Blood loss was higher in the ERAS group (37±36ml) compared to the non-ERAS group (22±17ml). The average flatus time of the traditional group was 3.0±1.3 days, higher than the ERAS group’s 2.0±0.9 days. Time for feeding was early in the ERAS group and later when waiting for bowel movements and flatus in the traditional group, with corresponding results of 1.3±0.6 days and 3.6±1.3 days. The median PLOS of the conventional group was 9.0 (4-38) days longer than the ERAS group, which was 7 (4-17) days. These differences are statistically significant (p<0.05). The proportion of patients with Clavien-Dindo classification ≥2 was 1.9% lower in the ERAS group than 5.6% in the non-ERAS group. This difference was not statistically significant, and no deaths occurred within 30 days after surgery.
Conclusions
Despite differences in tumor staging, operative time, and blood loss, the ERAS group showed better recovery times, shorter flatus times, and reduced hospital stays than the traditional group. While the complication rate in the ERAS group appeared lower, more extensive data is needed to confirm these findings.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.