Cristina B. Geltzeiler, MD, from the Oregon Health and Science University in Portland, and colleagues assessed practice patterns and patient outcomes for all elective colon and rectal resection cases performed in 2009 (prior to ERAS implementation), 2011, and 2012. The ERAS program involves multidisciplinary efforts from anesthesia, preadmission, nursing, and surgery staff.
The researchers found that over the study period the use of laparoscopy increased from 57.4 to 88.8% (P < 0.001) and was accompanied by a significant decrease in length of stay (LOS; 6.7 versus 3.7 days; P < 0.001), without an increase in 30-day readmission rate (P = 0.49). There were decreases in use of patient-controlled narcotic analgesia (P < 0.001) and duration of use (P = 0.02). There was a trend toward decreased ileus (P = 0.02) and intra-abdominal infection (P = 0.24). Colorectal cancer diagnosis was not significantly associated with LOS, 30-day readmission rates, ileus, and intra-abdominal infection (all P > 0.05).
"Length of stay reductions resulted in an estimated cost savings of $3,202 per patient (2011) and $4,803 per patient (2012)," the authors write.