AB047. Audit of enhanced recovery after surgery (ERAS) protocol for elective colorectal surgical procedures

Background: Enhanced recovery after surgery (ERAS) are proving to be the safest and most effective standards in managing elective colorectal cancer patients pre and post operatively. We aim to audit the current adherence to guidelines in all electively undertaken colorectal surgical procedures in a single centre.

Methods: A retrospective review of all patients admitted for elective colorectal surgery was carried out between 1st of January to 31st of December 2018. No emergency procedures were included. The anaesthetic component of the guidelines was excluded. Data was analysed for compliance with 5 pre-admission, 7 pre-operative, 4 Intra-operative and 10 post-operative criteria proposed by the ERAS guidelines.

Results: Forty-eight patients were initially found by the medical records department. Six of the charts were missing. Two patients were emergency procedures and excluded. Forty-one patients had their clinical records analysed. The adherence to pre-admission criteria was 59%, pre-operative criteria was 87.3%, intra-operative criteria was 70%, and post-operative criteria was 63.9%. Hence the overall adherence to guidelines was 70%. Mean length of stay (LOS) was 9.8 days.

Conclusions: We conclude that the colorectal unit is above average in compliance to the ERAS protocols, but we have a higher than standard mean hospital length of stay. Nevertheless, further improvement can be made by using measures to correct areas of deficiency such as, cessation of smoking and alcohol, as well as use of carbohydrate drinks pre-operatively. Homogeneous and accurate clerking may also aid in improving outcomes.

Keywords: Enhanced recovery protocol; elective colorectal surgery; guidelines; audit