EVALUATING THE EFFICACY OF ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOLS IN PATIENTS UNDERGOING ELECTIVE COLORECTAL SURGERY

Abstract

Background: Enhanced Recovery After Surgery (ERAS) protocols have been developed as evidence-based, multimodal perioperative care pathways aimed at reducing surgical stress, improving recovery, and minimizing complications. Objective: This study aimed to evaluate the efficacy of ERAS protocols in patients undergoing elective colorectal surgery. Methods: This prospective observational study was conducted at Shaikh Zayed hospital Lahore from October 2024 to March 2025. A total of 235 patients undergoing elective colorectal surgery were enrolled using consecutive sampling. All patients were managed according to standardized ERAS protocols, which included preoperative counseling and carbohydrate loading, opioid-sparing analgesia, avoidance of nasogastric tubes, early oral intake, and early mobilization. Results: The mean age of the cohort was 54.2 ± 12.7 years, with 138 males (58.7%) and 97 females (41.3%). Laparoscopic surgery was performed in 141 patients (60.0%) and open surgery in 94 patients (40.0%). The mean operative time was 168.5 ± 34.6 minutes, and the mean intraoperative blood loss was 210.3 ± 75.8 mL. Postoperative recovery was favorable, with a mean time to first bowel movement of 2.6 ± 0.9 days and mean hospital stay of 6.2 ± 2.1 days. Complications were observed in 52 patients (22.1%), the majority of which were Clavien–Dindo Grade I–II, and anastomotic leak occurred in 2.6% of cases. Conclusion: ERAS protocols significantly improve recovery in patients undergoing elective colorectal surgery by reducing complications, facilitating early mobilization, and shortening hospital stay without increasing readmission or mortality. The integration of laparoscopic techniques further enhances outcomes