ArticleBJS open2024
Impact of structured multicentre enhanced recovery after surgery (ERAS) protocol implementation on length of stay after colorectal surgery.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Challenges and solutions for colorectal surgery patients during hospital-to-home transitions: a scoping review.BMJ open · 2026Article
- A qualitative exploration of patient perspectives regarding patient education during their colorectal surgical experience.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Article
- Prognostic Value of the Preoperative Prognostic Nutritional Index in Predicting Survival Outcomes After Curative Surgery for Colorectal Cancer.Healthcare (Basel, Switzerland) · 2025Article
- Optimizing intraoperative conditions in patients undergoing elective colorectal surgery to prevent anastomotic leakage: SmartCheck study.The British journal of surgery · 2025Article
- Component-based approach of enhanced recovery after surgery protocols in bariatric surgery: A systematic review and meta-analysis of randomized controlled trials.Metabolism open · 2025Article
- The role of intraabdominal drain placement in minimal-invasive right hemicolectomy with complete mesocolic excision - a propensity score matched single center analysis.International journal of colorectal disease · 2025Article
- Review
- Effect of neoadjuvant therapy on textbook outcomes in minimally invasive rectal cancer surgery.World journal of surgical oncology · 2025Article
- Development of an evaluation index system for inappropriate hospital admissions after colorectal cancer surgery in the context of enhanced recovery after surgery.BMC nursing · 2025Article
- Length of stay after colorectal surgery in Italy: the gap between "fit for" and "actual" discharge in a prospective cohort of 4529 cases.Perioperative medicine (London, England) · 2025Article
- From meal to malfunction: exploring molecular pathways, biomarkers and interventions in postprandial cardiometabolic health.Frontiers in cardiovascular medicine · 2025Review
- Article
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4 authors.
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Abstract
backgroundIncreased length of stay after surgery is associated with increased healthcare utilization and adverse patient outcomes. While enhanced recovery after surgery (ERAS) protocols have been shown to reduce length of stay after colorectal surgery in trial settings, their effectiveness in real-world settings is more uncertain. The aim of this study was to assess the impact of ERAS protocol implementation on length of stay after colorectal surgery, using real-world data.
methodsIn 2012, ERAS protocols were introduced at 15 Ontario hospitals as part of the iERAS study. A cohort of patients undergoing colorectal surgery treated at these hospitals between 2008 and 2019 was created using health administrative data. Mean length of stay was computed for the intervals before and after ERAS implementation. Interrupted time series analyses were performed for predefined subgroups, namely all colorectal surgery, colorectal surgery without complications, right-sided colorectal surgery, and left-sided colorectal surgery. Sensitivity analyses were then conducted using adjusted length of stay, accounting for length of stay predictors, including: patient age, sex, marginalization, co-morbidities, and diagnosis; surgeon volume of cases, years in practice, and colorectal surgery expertise; hospital volume; and other contextual factors, including procedure type and timing, surgical approach, and in-hospital complications.
resultsA total of 32 612 patients underwent colorectal surgery during the study interval. ERAS implementation led to a decrease in length of stay of 1.05 days (13.7%). Larger decreases in length of stay were seen with more complex surgeries, with a level change of 1.17 days (15.6%) noted for the subgroup of patients undergoing left-sided colorectal surgery. The observed decreases in length of stay were durable for the length of the study interval in all analyses. When adjusting for predictors of length of stay, the effect of ERAS implementation on length of stay was larger (reduction of 1.46 days).
conclusionIntroducing formal ERAS protocols reduces length of stay after colorectal surgery significantly, independent of temporal trends toward decreasing length of stay. These effects are durable, demonstrating that ERAS protocol implementation is an effective hospital-level intervention to reduce length of stay after colorectal surgery.
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