Trial reportJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Adapted ERAS Pathway Versus Standard Care in Patients Undergoing Emergency Surgery for Perforation Peritonitis-a Randomized Controlled Trial.
Trial report in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 4 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
13 citing papers in PubMed, 4 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Effect of enhanced recovery after surgery protocols on mortality and morbidity after trauma and non-trauma emergency laparotomies: a systematic review and meta-analysis.Updates in surgery · 2026Pooled it
- Key interventions and outcomes in perioperative care pathways in emergency laparotomy: a systematic review.World journal of emergency surgery : WJES · 2025Pooled it
- Enhanced recovery after surgery protocols following emergency intra-abdominal surgery: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Pooled it
- Protocolized care pathways in emergency general surgery: a systematic review and meta-analysis.The British journal of surgery · 2024Pooled it
- Comparison of Short-Course and Conventional Antimicrobial Duration in Mild and Moderate Complicated Intra-Abdominal Infections: A randomised controlled trial.Sultan Qaboos University medical journal · 2023Trial
- Enhanced recovery protocols: compliance and outcome in elective vs. emergency colorectal surgery.Langenbeck's archives of surgery · 2026Article
- Enhanced Recovery After Surgery (ERAS) and Surgical Site Infections (SSIs).Antibiotics (Basel, Switzerland) · 2026Review
- Post-surgical diets in the ERAS protocol: D-ERAS scoping review.European journal of clinical nutrition · 2026Article
- Review
- Characterisation and evaluation of early mobilisation interventions after emergency laparotomy surgery: a scoping review.BJA open · 2025Review
- The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery.Ewha medical journal · 2023Review
- Enhanced perioperative care in emergency general surgery: the WSES position paper.World journal of emergency surgery : WJES · 2023Review
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnhanced Recovery After Surgery (ERAS) pathways have an uncertain role in emergencies. To the best of our knowledge, there are no trials studying ERAS in perforation peritonitis across the GI tract, despite it being a common surgical emergency.
aimsTo evaluate the safety, feasibility and efficacy of adapted ERAS protocols in emergency laparotomy for perforation peritonitis.
methodsThis was an open-labeled, superiority randomized controlled trial conducted between October 2018 and June 2020 in patients with perforation peritonitis assigned to standard care or adapted ERAS groups using block randomization. Patients with refractory shock, ASA class 4E, localized peritonitis, etc. were excluded. Components of the adapted ERAS protocol included epidural analgesia, goal-directed fluid therapy, avoidance of opioids, early mobilization, early removal of tubes, drains and catheters, and early enteral feeding. The primary outcome, length of hospitalization (LOH), and the secondary outcomes, functional recovery parameters, were analyzed between both the groups.
resultsA total of 59 patients in standard care group and 61 patients in adapted ERAS group were included and randomized, and were comparable in terms of demographic and clinico-pathological characteristics. LOH in adapted ERAS group was shorter by 3 days (p < 0.001), and patients showed reduction in time (days) to first flatus (2.84 vs 4.22, p < 0.001), first stool (4.38 vs 6.08, p < 0.001) and solid diet (4.67 vs 8.37, p < 0.001). Post-operative nausea, vomiting (p = 0.05) and surgical site infections (p < 0.001) were reduced in adapted ERAS group. Pre-existing malignancy, respiratory complications and high output stoma were reasons for delayed discharge in adapted ERAS group.
conclusionAdapted ERAS pathways considerably reduce LOH in patients undergoing emergency surgery for perforation peritonitis, with no adverse events in 30 days after discharge.
trial registrationRegistered at http://ctri.nic.in/Clinicaltrials/login.php (CTRI/2019/02/017537).
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