American journal of surgery · 2025
The impact of ERAS protocols on postoperative outcomes in robotic, laparoscopic, and open colorectal surgery: A multicenter retrospective study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Mohandes Bushra, Abukar Saido Haji, Ponholzer Florian, Öfner Dietmar, Enodien Bassey, Ortlieb Niklas, Flaifel Mariana, Frey Daniel M, Vorburger Stephan, Saad Baraa, Müller Sophie, Kollmann Cathérine, Kollmann Lars, Flemming Sven, Grass Julia Kristin, Melling Nathaniel, Rousek Michael, Abeciūnas Vilius, Poskus Tomas, Bardakcioglu Ovunc, Neumann Katerina, Gala-Lopez Boris L, Honaker Michael Drew, Steinemann Daniel, Müller Beat P, Zeindler Jasmin, Kollmar Otto, Heigl Andres, Rosenberg Robert, Taha-Mehlitz Stephanie, Taha Anas
Аннотация
BACKGROUND: Enhanced recovery after surgery (ERAS) protocols improve outcomes in colorectal surgery, but the impact of ERAS on comparative effectiveness across robotic, laparoscopic, and open approaches is unclear.
METHODS: In this multicenter retrospective study, 5503 patients undergoing elective colorectal surgery from 13 centers could be included. Patients were compared regarding surgical technique and ERAS adherence. Primary outcomes included postoperative complications and anastomotic leakage; secondary outcomes included length of hospital stay (LOS) and Comprehensive Complication Index (CCI). Multivariate regression assessed ERAS impact.
RESULTS: ERAS was used in 890 patients and associated with significantly shorter LOS across all modalities (robotic: 5.5 vs. 8.5 days; laparoscopic: 8.5 vs. 9.0 days; open: 13.1 vs. 14.5 days; p ≤ 0.02). ERAS independently reduced complication rates (p = 0.016) and anastomotic leaks (p = 0.007). Robotic surgery was protective against complications and linked to the greatest LOS reduction. ERAS did not significantly affect CCI.
CONCLUSIONS: ERAS protocols improve postoperative outcomes across colorectal surgical techniques, with the greatest benefits in robotic surgery, supporting their broad clinical implementation.
METHODS: In this multicenter retrospective study, 5503 patients undergoing elective colorectal surgery from 13 centers could be included. Patients were compared regarding surgical technique and ERAS adherence. Primary outcomes included postoperative complications and anastomotic leakage; secondary outcomes included length of hospital stay (LOS) and Comprehensive Complication Index (CCI). Multivariate regression assessed ERAS impact.
RESULTS: ERAS was used in 890 patients and associated with significantly shorter LOS across all modalities (robotic: 5.5 vs. 8.5 days; laparoscopic: 8.5 vs. 9.0 days; open: 13.1 vs. 14.5 days; p ≤ 0.02). ERAS independently reduced complication rates (p = 0.016) and anastomotic leaks (p = 0.007). Robotic surgery was protective against complications and linked to the greatest LOS reduction. ERAS did not significantly affect CCI.
CONCLUSIONS: ERAS protocols improve postoperative outcomes across colorectal surgical techniques, with the greatest benefits in robotic surgery, supporting their broad clinical implementation.