Réhabilitation améliorée après chirurgie colorectale : évaluation initiale des pratiques dans les services de chirurgie digestive du CHU de Nice

Abstract : Introduction
The concept of enhanced recovery after surgery (ERAS) is gaining considerable momentum and recommendations have been made by learned societies for improved recovery after colorectal surgery. The objective of our study was to assess the degree of implementation of these recommendations prior to the implementation of an ERAS program.
Methods
Patients scheduled for an elective colorectal surgery between November 2017 and April 2018 were included in our prospective single-center observational study. The primary endpoint was the degree of implementation of the recommendations. Mortality and morbidity at 30 days and length of stay were also analyzed.
Results
Seventy-six patients underwent surgery for colorectal cancer or diverticular disease. The median application of recommendations was 47.2% [38.9%; 52.6%]. The mortality was 6.76% and the overall morbidity 43.24%, including 6.76% severe surgical complications (Clavien III-IV). The rate of care-associated infections was 32.43%. The average hospital length of stay was 10.86 days (+/- 6.12).
Conclusion
In the absence of a coordinated ERAS strategy, the implementation of the recommendations is low, and the results of mortality, morbidity, care-associated infections and hospital length of stay are similar to those observed in previous studies. Better implementation of the recommendations should improve patients’ outcomes. This initial assessment will guide improvements measures. Progress in adhering to the recommendations will need to be reassessed, and patients mortality, morbidity, and length of stay will also be monitored. Enhanced recovery after colorectal surgery : Initial assessment of practices in visceral surgery department in CHU de Nice.
Document type :
Master Thesis
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Vincent Le Talec. Réhabilitation améliorée après chirurgie colorectale : évaluation initiale des pratiques dans les services de chirurgie digestive du CHU de Nice. Médecine humaine et pathologie. 2018. ⟨dumas-01984173⟩

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