There are significant changes in indicators. Improvement is gradual and progressive as years go by with regard to POEC development, and positively affects indicators improvement.
Background:Guidelines for enhanced recovery after surgery have their bases in colonic
surgery, through the first protocols published in 2012. Since then, this
practice has spread throughout the world, mainly due to improvements in
surgical outcomes associated with resource savings. Aim: To analyze the first prospective results after the implementation of the
guidelines. Methods:Were retrospectively analyzed 48 patients operated in the institution prior
to the standardization. This group was then compared with a series of 25
patients operated consecutively after the guidelines were implemented. Results:With a 68.6% compliance rate, hospital length of stay (p=0.002), use of
abdominal drains (p<0.001) and mechanical bowel preparation (p<0.001)
were reduced. Mortality rates, anastomotic fistula, abdominal abscesses and
reoperations were also reduced, but without statistical significance. Conclusion:Enhanced recovery after surgery protocols benefit patients care, resulting in
better outcomes and possibly resource savings. Even with some limitations,
its implementation is feasible in the Brazilian Public Health System.
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