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. 2022 Oct;36(10):7619-7627.
doi: 10.1007/s00464-022-09212-y. Epub 2022 May 2.

ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report

Marco Milone  1 , Ugo Elmore  2 , Michele Manigrasso  3 , Monica Ortenzi  4 , Emanuele Botteri  5 , Alberto Arezzo  6 , Gianfranco Silecchia  7 , Mario Guerrieri  4 , Giovanni Domenico De Palma  8 , Ferdinando Agresta  9 ; ERCOLE Study Group
Collaborators, Affiliations

ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report

Marco Milone et al. Surg Endosc. 2022 Oct.

Erratum in

Abstract

Background: Several reports demonstrated a strong association between the level of adherence to the protocol and improved clinical outcomes after surgery. However, it is difficult to obtain full adherence to the protocol into clinical practice and has still not been identified the threshold beyond which improved functional results can be reached.

Methods: The ERCOLE (ERas and COLorectal Endoscopic surgery) study was as a cohort, prospective, multi-centre national study evaluating the association between adherence to ERAS items and clinical outcomes after minimally invasive colorectal surgery. The primary endpoint was to associate the percentage of ERAS adherence to functional recovery after minimally invasive colorectal cancer surgery. The secondary endpoints of the study was to validate safety of the ERAS programme evaluating complications' occurrence according to Clavien-Dindo classification and to evaluate the compliance of the Italian surgeons to each ERAS item.

Results: 1138 patients were included. Adherence to the ERAS protocol was full only in 101 patients (8.9%), > 75% of the ERAS items in 736 (64.7%) and > 50% in 1127 (99%). Adherence to > 75% was associated with a better functional recovery with 90.2 ± 98.8 vs 95.9 ± 33.4 h (p = 0.003). At difference, full adherence to the ERAS components 91.7 ± 22.1 vs 92.2 ± 31.6 h (p = 0.8) was not associated with better recovery.

Conclusions: Our results were encouraging to affirm that adherence to the ERAS program up to 75% could be considered satisfactory to get the goal. Our study could be considered a call to simplify the ERAS protocol facilitating its penetrance into clinical practice.

Keywords: Colorectal; ERAS; Enhanced Recovery; Minimally invasive.

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Conflict of interest statement

Marco Milone, Ugo Elmore, Michele Manigrasso, Monica Ortenzi, Emanuele Botteri, Alberto Arezzo, Gianfranco Silecchia, Mario Guerrieri, Giovanni Domenico De Palma and Ferdinando Agresta have no conflicts of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Functional Recovery and Compliance to the ERAS
Fig. 2
Fig. 2
Complications’ occurrence and Compliance to the ERAS
See this image and copyright information in PMC

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