Evidence map›Paper›PMID 32972103›Full record

ArticleAnnals of coloproctology2022

Improved outcomes with implementation of an Enhanced Recovery After Surgery pathway for patients undergoing elective colorectal surgery in the Philippines.

Mayou Martin T Tampo, Mark Augustine S Onglao, Marc Paul J Lopez, Marie Dione P Sacdalan, Ma Concepcion L Cruz, Rosielyn T Apellido, Hermogenes J Monroy Iii

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Article in Annals of coloproctology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mayou Martin T TampoDivision of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Mark Augustine S OnglaoDivision of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Marc Paul J LopezDivision of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Marie Dione P SacdalanDivision of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Ma Concepcion L CruzDepartment of Anesthesiology, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Rosielyn T ApellidoDivision of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.
Hermogenes J Monroy IiiDivision of Colorectal Surgery, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to evaluate surgical outcomes (i.e. length of stay [LOS], 30-day morbidity, mortality, reoperation, and readmission rates) with the use of the Enhanced Recovery After Surgery (ERAS) pathway, and determine its association with the rate of compliance to the different ERAS components.

methodsThis was a prospective cohort of patients, who underwent the following elective procedures: stoma reversal (SR), colon resection (CR), and rectal resection (RR). The primary endpoint was to determine the association of compliance to an ERAS pathway and surgical outcomes. These were then retrospectively compared to outcomes prior to the implementation of ERAS.

resultsA total of 267 patients were included in the study. The overall compliance to the ERAS component was 92.0% (SR, 91.8%; CR, 93.1%; RR, 90.7%). There was an associated decrease in morbidity rates across all types of surgery, as compliance to ERAS increased. The average total LOS decreased in all groups but was only found to have statistical significance in SR (12.1±6.7 days vs. 10.0±5.4 days, P=0.002) and RR (19.9±11.4 days vs. 16.9±10.5 days, P=0.04) groups. Decreased postoperative LOS was noted in all groups. Morbidity rates were significantly higher after ERAS implementation, but reoperation and mortality rates were found to be similar.

conclusionIncreased compliance to ERAS protocol is associated with a decrease in morbidity across all surgery types. The implementation of an ERAS protocol significantly decreased mean hospital LOS, without any increase in major surgical complications. Having your own hospital ERAS pathway improves documentation and accuracy of reporting surgical complications.

Indexed as

ComplianceEnhanced Recovery After SurgeryLength of stay

Identifiers

PMID32972103
PMCPMC9021849

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