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Article

Enhanced Recovery after Surgery (ERAS) Protocol Is a Safe and Effective Approach in Patients with Gastrointestinal Fistulas Undergoing Reconstruction: Results from a Prospective Study

1
Surgical Oncology Clinic, National Cancer Institute, 31-115 Krakow, Poland
2
General Surgery Unit with Intestinal Failure Center, Stanley Dudrick’s Memorial Hospital, 32-082 Skawina, Poland
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Department of Medical Education, Jagiellonian University Medical College, 30-688 Krakow, Poland
4
2nd Department of General Surgery, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland
*
Author to whom correspondence should be addressed.
Academic Editor: Misha D. P. Luyer
Nutrients 2021, 13(6), 1953; https://doi.org/10.3390/nu13061953
Received: 27 April 2021 / Revised: 3 June 2021 / Accepted: 4 June 2021 / Published: 7 June 2021
(This article belongs to the Section Clinical Nutrition)
Background and Aims: An enterocutaneous fistula (ECF) poses a major surgical problem. The definitive surgical repair of persistent fistulas remains a surgical challenge with a high rate of re-fistulation and mortality, and the reasons for that is not the surgical technique alone. Enhanced Recovery after Surgery (ERAS®) is an evidence-based multimodal perioperative protocol proven to reduce postoperative complications. The aim of the study was to assess the clinical value of the ERAS protocol in surgical patients with ECF. Methods: ERAS protocol was used in all patients scheduled for surgery for ECF at the Stanley Dudrick’s Memorial Hospital in Skawina between 2011 and 2020. A multidisciplinary team (MDT) was in charge of the program and performed annual audits. A consecutive series of 100 ECF patients (44 females, 56 males, mean age 54.1 years) were evaluated. Postoperative complications rate, readmission rate, length of hospital stay, prevalence of postoperative nausea and vomiting were assessed. Registered under ClinicalTrials.gov Identifier no. NCT04771832. Results: ERAS protocol was successfully introduced for ECF surgeries; however, eight modifications to the ERAS program was performed in 2015. They led to improvement of surgical outcomes: reduction of postoperative nausea and vomiting (15 vs. 17% patients, p = 0.025), overall complication rate (11 vs. 10, p = 0.021), median length of hospital stay (overall and after surgery, p = 0.022 and 0.002, respectively). Conclusions: ERAS protocol can be successfully used for ECF patients. Prescheduled audits can contribute to the improvement of care. View Full-Text
Keywords: ERAS; gastrointestinal surgery; GI tract; reconstruction ERAS; gastrointestinal surgery; GI tract; reconstruction
MDPI and ACS Style

Klek, S.; Salowka, J.; Choruz, R.; Cegielny, T.; Welanyk, J.; Wilczek, M.; Szczepanek, K.; Pisarska-Adamczyk, M.; Pedziwiatr, M. Enhanced Recovery after Surgery (ERAS) Protocol Is a Safe and Effective Approach in Patients with Gastrointestinal Fistulas Undergoing Reconstruction: Results from a Prospective Study. Nutrients 2021, 13, 1953. https://doi.org/10.3390/nu13061953

AMA Style

Klek S, Salowka J, Choruz R, Cegielny T, Welanyk J, Wilczek M, Szczepanek K, Pisarska-Adamczyk M, Pedziwiatr M. Enhanced Recovery after Surgery (ERAS) Protocol Is a Safe and Effective Approach in Patients with Gastrointestinal Fistulas Undergoing Reconstruction: Results from a Prospective Study. Nutrients. 2021; 13(6):1953. https://doi.org/10.3390/nu13061953

Chicago/Turabian Style

Klek, Stanislaw, Jerzy Salowka, Ryszard Choruz, Tomasz Cegielny, Joanna Welanyk, Mariusz Wilczek, Kinga Szczepanek, Magdalena Pisarska-Adamczyk, and Michal Pedziwiatr. 2021. "Enhanced Recovery after Surgery (ERAS) Protocol Is a Safe and Effective Approach in Patients with Gastrointestinal Fistulas Undergoing Reconstruction: Results from a Prospective Study" Nutrients 13, no. 6: 1953. https://doi.org/10.3390/nu13061953

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