Jessica Capre-Pereira, Servicio de Cirugía de Colon y Recto, Fundación Valle del Lili, Cali; Docencia Programa de Coloproctología, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
Helber F. Pérez-Imbachí, Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali; Facultad de Ciencias de la Salud, Universidad ICESI, Cali; Capítulo de Futuros Cirujanos, Asociación Colombiana de Cirugía, Bogotá; Colombia
Andrés Gempeler, Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali; Facultad de Ciencias de la Salud, Universidad ICESI, Cali; Colombia
Juan G. Holguín-Henao, Servicio de Cirugía de Colon y Recto, Fundación Valle del Lili, Cali; Docencia Programa de Coloproctología, Facultad de Ciencias de la Salud, Universidad ICESI, Cali; Colombia
Alexander Obando, Servicio de Cirugía de Colon y Recto, Fundación Valle del Lili, Cali; Docencia Programa de Coloproctología, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
Iván Guerrero, Programa de Coloproctología, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
Estefanía Gallego, Capítulo de Futuros Cirujanos, Asociación Colombiana de Cirugía, Bogotá, Colombia
Santiago Hoyos, Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
Einar Billefals, Servicio de Anestesiología, Fundación Valle del Lili, Cali, Colombia
Mauricio Burbano, Servicio de Anestesiología, Fundación Valle del Lili, Cali, Colombia
Mónica Bejarano, Servicio de Cirugía General, Fundación Valle del Lili, Cali, Colombia
Catalina Ruiz, Residencia de Cirugía General, Universidad del Valle, Cali, Colombia
Abraham Kestenberg, Servicio de Cirugía de Colon y Recto, Fundación Valle del Lili, Cali; Docencia Programa de Coloproctología, Facultad de Ciencias de la Salud, Universidad ICESI, Cali; Colombia
Objective: To evaluate the impact of the Enhanced Recovery After Surgery (ERAS) protocol in oncologic colorectal surgery in our region, assessing its effects on reducing postoperative complications, hospital stay, and early intestinal recovery. Methods: A trial emulation study with historical controls was conducted based on the review of medical records of adult patients undergoing colorectal oncologic surgery before and after ERAS implementation. Clinical outcomes were compared between groups, including postoperative complications, intensive care unit (ICU) admission, reoperations, intestinal recovery, and pain control. Poisson regression models adjusted for clinical factors were used to calculate relative risks. Results: A total of 183 patients were analyzed, 59 in the standard care group and 124 in the ERAS group. Patients in the ERAS group experienced earlier intestinal recovery, as evidenced by the first passage of stool (p = 0.002), flatus (p < 0.001), oral tolerance (p < 0.001), and better postoperative pain control (p = 0.014). In the multivariate analysis, ERAS patients showed a 72% relative risk reduction in ICU admission, 81% in perioperative ICU admission, 58% in surgical reoperations, and 54% in postoperative complications. Conclusions: The implementation of ERAS in oncologic colorectal surgery was associated with improved clinical outcomes, including lower morbidity, faster recovery, and better pain control. Adherence to the protocol and a multidisciplinary approach are essential for its success.
Keywords: Enhanced recovery after surgery. Colorectal cancer. Laparoscopy. Postoperative complications.