ERas and COLorectal endoscopic surgery: an Italian society for endoscopic surgery and new technologies (SICE) national report.
Colorectal
ERAS
Enhanced Recovery
Minimally invasive
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
23
08
2021
accepted:
29
01
2022
pubmed:
3
5
2022
medline:
23
9
2022
entrez:
2
5
2022
Statut:
ppublish
Résumé
Several reports demonstrated a strong association between the level of adherence to the protocol and improved clinical outcomes after surgery. However, it is difficult to obtain full adherence to the protocol into clinical practice and has still not been identified the threshold beyond which improved functional results can be reached. The ERCOLE (ERas and COLorectal Endoscopic surgery) study was as a cohort, prospective, multi-centre national study evaluating the association between adherence to ERAS items and clinical outcomes after minimally invasive colorectal surgery. The primary endpoint was to associate the percentage of ERAS adherence to functional recovery after minimally invasive colorectal cancer surgery. The secondary endpoints of the study was to validate safety of the ERAS programme evaluating complications' occurrence according to Clavien-Dindo classification and to evaluate the compliance of the Italian surgeons to each ERAS item. 1138 patients were included. Adherence to the ERAS protocol was full only in 101 patients (8.9%), > 75% of the ERAS items in 736 (64.7%) and > 50% in 1127 (99%). Adherence to > 75% was associated with a better functional recovery with 90.2 ± 98.8 vs 95.9 ± 33.4 h (p = 0.003). At difference, full adherence to the ERAS components 91.7 ± 22.1 vs 92.2 ± 31.6 h (p = 0.8) was not associated with better recovery. Our results were encouraging to affirm that adherence to the ERAS program up to 75% could be considered satisfactory to get the goal. Our study could be considered a call to simplify the ERAS protocol facilitating its penetrance into clinical practice.
Sections du résumé
BACKGROUND
Several reports demonstrated a strong association between the level of adherence to the protocol and improved clinical outcomes after surgery. However, it is difficult to obtain full adherence to the protocol into clinical practice and has still not been identified the threshold beyond which improved functional results can be reached.
METHODS
The ERCOLE (ERas and COLorectal Endoscopic surgery) study was as a cohort, prospective, multi-centre national study evaluating the association between adherence to ERAS items and clinical outcomes after minimally invasive colorectal surgery. The primary endpoint was to associate the percentage of ERAS adherence to functional recovery after minimally invasive colorectal cancer surgery. The secondary endpoints of the study was to validate safety of the ERAS programme evaluating complications' occurrence according to Clavien-Dindo classification and to evaluate the compliance of the Italian surgeons to each ERAS item.
RESULTS
1138 patients were included. Adherence to the ERAS protocol was full only in 101 patients (8.9%), > 75% of the ERAS items in 736 (64.7%) and > 50% in 1127 (99%). Adherence to > 75% was associated with a better functional recovery with 90.2 ± 98.8 vs 95.9 ± 33.4 h (p = 0.003). At difference, full adherence to the ERAS components 91.7 ± 22.1 vs 92.2 ± 31.6 h (p = 0.8) was not associated with better recovery.
CONCLUSIONS
Our results were encouraging to affirm that adherence to the ERAS program up to 75% could be considered satisfactory to get the goal. Our study could be considered a call to simplify the ERAS protocol facilitating its penetrance into clinical practice.
Identifiants
pubmed: 35501602
doi: 10.1007/s00464-022-09212-y
pii: 10.1007/s00464-022-09212-y
pmc: PMC9485180
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
7619-7627Investigateurs
Ferdinando Agresta
(F)
Francesco Pizza
(F)
Dario D'Antonio
(D)
Francesco Amalfitano
(F)
Francesco Selvaggi
(F)
Guido Sciaudone
(G)
Lucio Selvaggi
(L)
Daniela Prando
(D)
Fabio Cavallo
(F)
Mario Guerrieri
(M)
Monica Ortenzi
(M)
Giovanni Lezoche
(G)
Diego Cuccurullo
(D)
Ernesto Tartaglia
(E)
Carlo Sagnelli
(C)
Andrea Coratti
(A)
Angela Tribuzi
(A)
Michele Di Marino
(M)
Gabriele Anania
(G)
Cristina Bombardini
(C)
Mauro Pietro Zago
(MP)
Fulvio Tagliabue
(F)
Morena Burati
(M)
Salomone Di Saverio
(S)
Samuele Colombo
(S)
Sara El Adla
(SE)
Maurizio De Luca
(M)
Monica Zese
(M)
Dario Parini
(D)
Paolo Prosperi
(P)
Giovanni Alemanno
(G)
Jacopo Martellucci
(J)
Stefano Olmi
(S)
Alberto Oldani
(A)
Matteo Uccelli
(M)
Dario Bono
(D)
Donatella Scaglione
(D)
Roberto Saracco
(R)
Mauro Podda
(M)
Adolfo Pisanu
(A)
Valentina Murzi
(V)
Antonino Agrusa
(A)
Salvatore Buscemi
(S)
Irnerio Angelo Muttillo
(IA)
Biagio Picardi
(B)
Edoardo Maria Muttillo
(EM)
Leonardo Solaini
(L)
Davide Cavaliere
(D)
Giorgio Ercolani
(G)
Francesco Corcione
(F)
Roberto Peltrini
(R)
Umberto Bracale
(U)
Andrea Lucchi
(A)
Laura Vittori
(L)
Michele Grassia
(M)
Alberto Porcu
(A)
Teresa Perra
(T)
Claudio Feo
(C)
Pierluigi Angelini
(P)
Domenico Izzo
(D)
Luigi Ricciardelli
(L)
Mario Trompetto
(M)
Gaetano Gallo
(G)
Alberto Realis Luc
(AR)
Andrea Muratore
(A)
Marcello Calabrò
(M)
Bruno Cuzzola
(B)
Andrea Barberis
(A)
Federico Costanzo
(F)
Giulio Angelini
(G)
Graziano Ceccarelli
(G)
Fabio Rondelli
(F)
Michele De Rosa
(M)
Elisa Cassinotti
(E)
Luigi Boni
(L)
Ludovica Baldari
(L)
Paolo Pietro Bianchi
(PP)
Giampaolo Formisano
(G)
Giuseppe Giuliani
(G)
Andrea Alessandro Pisani Ceretti
(AAP)
Nicolò Maria Mariani
(NM)
Marco Giovenzana
(M)
Roberto Farfaglia
(R)
Paolo Marcianò
(P)
Valeria Arizzi
(V)
Micaela Piccoli
(M)
Francesca Pecchini
(F)
Gianmaria Casoni Pattacini
(GC)
Emanuele Botteri
(E)
Nereo Vettoretto
(N)
Claudio Guarnieri
(C)
Letizia Laface
(L)
Emmanuele Abate
(E)
Massimiliano Casati
(M)
Carlo Feo
(C)
Nicolò Fabri
(N)
Antonio Pesce
(A)
Piero Maida
(P)
Giampaolo Marte
(G)
Roberta Abete
(R)
Lorenzo Casali
(L)
Alessandro Marchignoli
(A)
Matteo Dall'Aglio
(M)
Stefano Scabini
(S)
Davide Pertile
(D)
Alessandra Aprile
(A)
Jacopo Andreuccetti
(J)
Alberto Di Leo
(A)
Lorenzo Crepaz
(L)
Francesco Maione
(F)
Sara Vertaldi
(S)
Alessia Chini
(A)
Riccardo Rosati
(R)
Francesco Puccetti
(F)
Giulia Maggi
(G)
Andrea Cossu
(A)
Alberto Sartori
(A)
Maurizio De Luca
(M)
Giacomo Piatto
(G)
Nicola Perrotta
(N)
Marta Celiento
(M)
Marco Scorzelli
(M)
Vincenzo Pilone
(V)
Salvatore Tramontano
(S)
Pietro Calabrese
(P)
Raffaele Sechi
(R)
Nicola Cillara
(N)
Giaime Putzu
(G)
Michele Guido Podda
(MG)
Mauro Montuori
(M)
Enrico Pinotti
(E)
Giuseppe Sica
(G)
Marzia Franceschilli
(M)
Bruno Sensi
(B)
Maurizio Degiuli
(M)
Rossella Reddavid
(R)
Lucia Puca
(L)
Marco Farsi
(M)
Alessio Minuzzo
(A)
Elena Gia
(E)
Gian Luca Baiocchi
(GL)
Valerio Ranieri
(V)
Andrea Celotti
(A)
Francesco Bianco
(F)
Sebastiano Grassia
(S)
Alessandra Novi
(A)
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2022. The Author(s).
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