Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May;37(5):1151-1159.
doi: 10.1007/s00384-022-04155-1. Epub 2022 Apr 26.

Effect of implementation of enhanced recovery after surgery (ERAS) protocol and risk factors on 3-year survival after colorectal surgery for cancer-a retrospective cohort of 1001 patients

Fatah Tidadini  1   2 , Aline Bonne  1 , Bertrand Trilling  1 , Jean-Louis Quesada  3 , Pierre-Yves Sage  1 , Alison Foote  1 , Catherine Arvieux  1   2 , Jean-Luc Faucheron  4
Affiliations

Effect of implementation of enhanced recovery after surgery (ERAS) protocol and risk factors on 3-year survival after colorectal surgery for cancer-a retrospective cohort of 1001 patients

Fatah Tidadini et al. Int J Colorectal Dis. 2022 May.

Abstract

Purpose: Several recent studies have shown that the enhanced recovery after surgery (ERAS) protocol reduces morbidity and mortality and shortens the length of stay compared to conventional recovery strategy (pre-ERAS). The aim of this study was to evaluate the effect of the implementation of this protocol on 3-year overall survival and postoperative outcome in patients undergoing colorectal resection for cancer.

Methods: This was a retrospective, single-center, comparative, and non-randomized study. Between January, 2005, and December, 2017, 1001 patients were included (ERAS, n = 497; pre-ERAS, n = 504).

Results: The 3-year overall survival rate was significantly better for ERAS than for pre-ERAS patients (76.1 vs 69.2%; p = 0.017). The length of hospital stay (median 10 days vs 15; p = ≤ 0.001) and the 90-day readmission rate (15 vs 20%; p = 0.037) were significantly lower in the ERAS group. Three-year recurrence-free survival (p = 0.398) and 90-day complications (p = 0.560) were similar in the two groups. Analysis of 3-year survival by a multivariate Cox model identified ERAS as a protective factor with a 30% reduction in the risk of death: (HR = 0.70 [0.55-0.90]).

Conclusion: The implementation of the ERAS protocol was associated with an improvement in 3-year survival, a reduction of the length of hospital stay and the rate of readmission. ERAS is associated with better 3-year survival, independent of other commonly considered parameters. An ASA score > 2, smoking, a history of cancer, and atrial fibrillation are deleterious risk factors linked to earlier mortality.

Keywords: Colorectal cancer; Colorectal resection; Enhanced recovery after surgery (ERAS); Overall survival; Postoperative complications.

PubMed Disclaimer

References

    1. World Health Organization (WHO) fact sheet - Cancer. Accessed 16 Jul 2021. https://www.who.int/fr/news-room/fact-sheets/detail/cancer
    1. Chang GJ, Kaiser AM, Mills S, Rafferty JF, Buie WD (2012) Standards practice task force of the American society of colon and rectal surgeons. Practice parameters for the management of colon cancer. Dis Colon Rectum 55(8):831–843 - DOI
    1. Monson JRT, Weiser MR, Buie WD et al (2013) Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum 56(5):535–550 - DOI
    1. Schilling PL, Dimick JB, Birkmeyer JD (2008) Prioritizing quality improvement in general surgery. J Am Coll Surg 207(5):698–704 - DOI
    1. Artinyan A, Orcutt ST, Anaya DA, Richardson P, Chen GJ, Berger DH (2015) Infectious postoperative complications decrease long-term survival in patients undergoing curative surgery for colorectal cancer: a study of 12,075 patients. Ann Surg 261(3):497–505 - DOI