Enhanced recovery after emergency surgery: A systematic review

Abstract

To evaluate the present scientific evidence for feasibility and efficacy of enhanced recovery after surgery (ERAS) protocol in emergency surgery compared to conventional care in terms of LOH, postoperative complications, early functional recovery, re-occurrence and mortality. Method: Studies and relevant literature comparing the effects of enhanced recovery after surgery and conventional care for emergency surgery were identified in PubMed and Google Scholar. Out of the 340 studies generated, 10 eligible papers were selected for analysis which included 6 RCTs and 4 cohort studies. Data extracted for analysis consisted of: patient age, type of surgery performed, ERAS elements implemented, surgical outcomes in terms of postoperative complications, mortality, length of stay and reoccurrence rates. Results: Based on the outcome of 1802 patients, in comparison with conventional care, ERAS protocol resulted in significant decrease in length of hospitalization and complications. Functional recovery parameters like early removal of nasogastric tube, drain and early semisolid diet showed better outcomes in ERAS than conventional care. More research is required to confirm the effect of ERAS protocol on morbidity and reoccurrence. Conclusion: ERAS is feasible and efficient in emergency surgery compared to conventional care resulting in better and early patient recovery.