EP.TH.282Adherence to ERAS® Society recommendations following elective colonic surgery (2012) in regard to urinary drainage, postoperative nutritional care and intra-abdominal drainage

Abstract

Aims Evaluating adherence to ERAS® recommendations for post-operative urinary drainage, nutritional care and intra-abdominal drain placement in elective colorectal surgery. Methods Approval was obtained by the audit department of a university teaching hospital. Data was collected prospectively over a seven-week period for nineteen (n = 19) patients. Results were compared against the standard set by the ERAS® Society (2012). Results Right colonic surgery (n = 5): catheter removed on post-operative day (POD) 1 n = 1 (20%), normal diet started on POD 0 or 1 n = 3 (60%), IV fluids discontinued on POD 1 n = 3 (60%) and n = 4 (80%) did not have a drain placed. High anterior resection or left/subtotal colectomy (n = 9): catheter removed on POD 1 n = 3 (33%), normal diet started on POD 0 or 1 n = 4 (44%), IV fluids discontinued on POD 1 n = 3 (33%) and n = 2 (22%) did not have a drain placed. Low rectal surgery (n = 4*, *one patient, n = 1, excluded from all domains except intra-abdominal drainage due to immediate post-op complication): catheter removed on POD 3 n = 4 (100%), normal diet started on POD 0 or 1 n = 2 (50%), IV fluids discontinued on POD 1 n = 1 (25%) and all patients had a drain placed n = 5 (100%). Conclusions Adherence for urinary drainage in low rectal surgery and intra-abdominal drainage for right colonic surgery was satisfactory. Multiple areas of improvement were identified, in order to optimise compliance, and recommendations were generated. The exception may be drains for lower rectal surgery where recent data has recommended selective drain placement.