V1 Enhanced Recovery After Surgery (ERAS) compliance in elective colorectal surgery: an international multicentre survey

INTRODUCTION: ERAS protocols are widely endorsed after colorectal surgery. This study aims to describe compliance with the individual principles of ERAS across an international setting. METHODS: A hospital-level survey was administered. This aimed to describe hospital-level compliance to 17 principles of ERAS after elective colorectal surgery. The questionnaire was mandatory for all hospitals participating in an international cohort study on colorectal surgery between October 2017 and July 2018. RESULTS: A total of 422 hospitals took part in the cohort study and submitted questionnaires. Most hospitals (90%) were located in Europe. The overall median compliance was 14 out of 17 items. Only 13.7% of centres were compliant with all 17 items. High compliance was noted for items: patient counseling (91%); antibiotic prophylaxis (91.5%); venous thromboembolism prophylaxis (98.8%); early mobilization (97.2%); and avoidance of hypothermia (92.5%). Lower compliance was noted for items: preoperative oral carbohydrates (55.4%), standardized anesthesia protocol, (68.6%), early oral tolerance (69.8%), avoidance of abdominal drain (64.4%), and avoidance of mechanical bowel preparation (59.3%). CONCLUSION: Overall compliance with ERAS guidelines was high however there is still scope for improvement. New strategies should be considered to attain full adherence to ERAS guidelines in the management of patients undergoing elective colorectal surgery.