Safety and Feasibility of Enhanced Recovery after Surgery (ERAS) Protocol in Patients Undergoing Stoma Closure

Enhanced Recovery after Surgery (ERAS) protocol is a multimodal approach which includes variety of pre-, intra-, and postoperative components to minimize surgical trauma, reduce complications, and decrease hospital length of stay, while expediting accelerated recovery following elective procedures. This study aimed to compare the postoperative outcome using the conventional management versus ERAS protocol in patients undergoing stoma (ileostomy and colostomy) closure. A prospective, comparative, longitudinal study was conducted using census technique in 30 patients admitted to surgery department, between January 2018 and March 2019 for ileostomy or colostomy closure. The postoperative length of hospital stay, readmission, morbidity, and mortality were compared between two groups of participants undergoing stoma closure either by ERAS (group A, n = 15) or by conventional care (group B, n = 15) protocol. Chi-square test and Student t test were used for analysis. The mean postoperative length of hospital stay was shorter in ERAS group compared with conventional care group (1.5 vs. 6.5 days, p < 0.001). However, no statistically significant differences were reported in terms of readmission and morbidity between the two groups. One major morbidity (anastomotic leak) in conventional group was reported. There was no 30-day mortality in either group. In comparison with the conventional care group, the application of ERAS protocol in the stoma closure resulted in decreased postoperative length of hospital stay. No differences were observed for readmission, re-exploration, and other postoperative morbidities between the two groups.