Evaluation of Enhanced Recovery after Colorectal Surgery Outcomes in Adult Oncology Patients: A Retrospective Chart Review

Abstract

Cancers of the colon and rectum are amongst the most common worldwide and are often treated with surgical resection. Surgery for colorectal cancer is associated increased mortality and length of hospital stay. A local cancer center in Buffalo, NY utilizes Enhanced Recovery After Surgery (ERAS) for all their gastrointestinal patients and is seeking to evaluate its effectiveness in adult colorectal cancer patients. ERAS is a multimodal perioperative care pathway that seeks to reduce surgical stress, postoperative complications, and length of hospital stay. ERAS does this through the use of extensive preoperative education, minimally invasive techniques, and early postoperative nutrition and ambulation. Current literature indicates that ERAS appears to be safe and effective for use in colorectal cancer patients, but that there is a need for more current randomized controlled trials with larger sample sizes. A single-center retrospective chart review was done to determine if ERAS decreases length of hospital stay, 30-day readmissions, and postoperative complications in colorectal cancer patients compared to traditional perioperative care. Data analysis included chi-square analysis between ERAS and postoperative complications, and the Mann-Whitney test between ERAS and both length of hospital stay and 30-day readmissions. Correlations, chi-square analysis, and the Mann-Whitney test were performed between all three dependent variables and the covariates of age, surgical risk, and gender. ERAS was found to significantly decrease length of hospital stay without increasing the risk for 30-day readmissions or postoperative complications. Therefore, ERAS is safe and effective for use in this patient population. This study acts as a stepping-stone in supporting the implementation of ERAS in other oncologic fields in the U.S. population.