The Ewha Medical Journal
Ewha Womans University School of Medicine
Review

Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review

Ji Hyeong Song1, Minsung Kim2,*
1Department of Surgery, Inje University Haeundae Paik Hospital, Busan 48108, Korea.
2Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea.
*Corresponding Author: Minsung Kim, Department of Surgery, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea, Republic of. E-mail: bongkay4@gmail.com.

© Copyright 2024 Ewha Womans University School of Medicine. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: Oct 07, 2024; Revised: Oct 09, 2024; Accepted: Oct 10, 2024

Published Online: Oct 31, 2024

Abstract

Enhanced recovery after surgery (ERAS) protocols are designed to minimize surgical stress, preserve physiological function, and expedite recovery through standardized perioperative care for primary colorectal surgery patients. This narrative review explores the benefits of current ERAS protocols in improving outcomes for these patients and provides insights into future advancements. Numerous studies have shown that ERAS protocols significantly reduce the length of hospital stays by several days compared to conventional care. Additionally, the implementation of ERAS is linked to a reduction in postoperative complications, including lower incidences of surgical site infections, anastomotic leaks, and postoperative ileus. Patients adhering to ERAS protocols also benefit from quicker gastrointestinal recovery, marked by an earlier return of bowel function. Some research indicates that colorectal cancer patients undergoing surgery with ERAS protocols may experience improved overall survival rates. High compliance with ERAS protocols leads to better outcomes, yet achieving full adherence continues to be a challenge. Despite these advantages, implementation challenges persist, with compliance rates affected by varying clinical practices and resource availability. However, the future of ERAS looks promising with the incorporation of prehabilitation strategies and technologies such as wearable devices and telemedicine. These innovations provide real-time monitoring, enhance patient engagement, and improve postoperative follow-up, potentially transforming perioperative care in colorectal surgery and offering new avenues for enhanced patient outcomes.

Keywords: Colorectal neoplasms; Colorectal surgery; Enhanced recovery after surgery; Postoperative complications; Preoperative care