Evidence map›Paper›PMID 40269829›Full record

ArticleBMC surgery2025

Introducing enhanced recovery after surgery (ERAS) program in Rwanda: a step-by-step approach from KAP study to protocol development and preliminary implementation.

Martin Nyundo, Miguel Gasakure, Esperance Muhawenayo, King Kayondo, Paulin Banguti, Jean Damascene Twagirumukiza, Julien Gashegu, Olivier Detry

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In one paragraph

Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–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

5 citing papers in PubMed.

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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

8 authors.

Martin NyundoDepartment of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda. nyundomartin@gmail.com.
Miguel GasakureDepartment of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda.
Esperance MuhawenayoDepartment of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda.
King KayondoDepartment of Surgery, Rwanda Military Hospital, Kigali, Rwanda.
Paulin BangutiDepartment of Anesthesia and Critical Care, University of Rwanda, Kigali, Rwanda.
Jean Damascene TwagirumukizaDepartment of Surgery, Inkuru Nziza Orthopedic Hospital, Kigali, Rwanda.
Julien GasheguDepartment of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Kigali, Rwanda.
Olivier DetryDepartment of Abdominal Surgery and Transplantation, CHU Liege, University of Liege, Liege, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced Recovery After Surgery (ERAS) programs improve postoperative outcomes through evidence-based practices. However, implementing ERAS in resource-limited settings like Rwanda remains challenging. This study aimed to introduce an ERAS program at the Centre Hospitalier Universitaire de Kigali (CHUK) by tailoring it to the local context.

methodsA multi-phase strategy was employed, beginning with a Knowledge, Attitudes, and Practices (KAP) study following an ERAS webinar to identify gaps in awareness and application of ERAS principles among perioperative care providers. Targeted training sessions were conducted to address these gaps, leading to the development of a locally adapted ERAS protocol.

resultsThe KAP study revealed limited awareness of ERAS protocols, including international Nil Per Os (NPO) guidelines, with only 45.7% of participants familiar with them and 48% unknowingly applying some ERAS elements. Early postoperative feeding was supported by 45.7%, and 92.5% agreed that preventing nausea and vomiting enhances recovery. Regarding opioid use, 88.4% supported selective use, while 81.5% disagreed with eliminating opioids entirely. Almost all respondents (97.7%) believed ERAS improved perioperative care, and 79.2% felt it reduced hospital expenses. Additionally, 85% of respondents recognized laparoscopic surgery as enhancing ERAS protocols. The insights gained informed the design of targeted training sessions and the development of a locally adapted ERAS protocol, supported by the formation of collaborative groups and ERAS champions.

conclusionThe introduction of ERAS at CHUK demonstrates the feasibility of implementing evidence-based surgical protocols in resource-limited settings. Addressing knowledge gaps and adapting protocols to the local context represent a promising step toward improving surgical care in Rwanda and enhancing perioperative management. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Enhanced Recovery After SurgeryHealth Knowledge, Attitudes, PracticePerioperative CareAdultClinical ProtocolsFemaleHumansMaleProgram DevelopmentRwandaEnhanced recovery after surgeryEvidence-based practicesHealthcare implementationLaparoscopic surgeryPerioperative protocolsResource-limited healthcareSurgical care improvement

Identifiers

PMID40269829
PMCPMC12016112

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.