Enhanced Recovery After Surgery (ERAS) Protocols in Colorectal Surgery: A Systematic Review of Clinical Outcomes

Abstract

Introduction: Enhanced Recovery After Surgery (ERAS) protocols are multimodal, evidence-based care pathways designed to reduce surgical stress and accelerate recovery. This review evaluates the impact of ERAS protocols on clinical outcomes in patients undergoing colorectal surgery.

Methods: A systematic search of RCTs was performed, comparing ERAS protocols to traditional perioperative care in elective colorectal surgery. Primary outcomes were length of hospital stay (LOS) and overall postoperative complication rates.

Results: The meta-analysis of 30 RCTs demonstrated that the implementation of ERAS protocols resulted in a statistically significant reduction in mean LOS by approximately 2-3 days. Furthermore, ERAS was associated with a significant decrease in overall morbidity, particularly in rates of ileus and pulmonary complications, without increasing readmission rates.

Discussion: The synergistic effect of multiple interventions, including preoperative counseling, optimized fluid management, and early mobilization, is key to the success of ERAS. Successful implementation requires a dedicated multidisciplinary team.

Conclusion: ERAS protocols are superior to traditional care, safely reducing hospital stay and postoperative complications in colorectal surgery.