E.R.A.S. (Enhanced Recovery After Surgery)

Enhanced Recovery After Surgery

A medical revolution to help Patients recover faster after surgery

 

 

You can watch a video on ERAS with English subtitles by cliking on the YouTube logo below :

 

What is ERAS about?

Enhanced Recovery After Surgery (“ERAS”) consists in reducing as much as possible the undesirable side effects of surgery so that the Patient can feel better faster.

 

This approach has been implemented for several years in various countries, more specifically in the Scandinavian area.

 

It is an evidence-based-medicine for which each care is assessed and optimized, taking into account the benefit/ risk approach.

 

At the end, the Patient walks out more rapidly and in better shape, therefore reducing the complication risk (among which the Hospital-acquired infections).

 

 

How does it work?

The patient walks in the best possible shape for the surgery

 

 He is informed of his care pathways and knows the major cares he will receive prior and after the surgery itself.  He also knows exactly what he will be asked to do every day, in terms of autonomy.

In order to improve his resistance and/or depending on the considered surgery, rehabilitation sessions and/or nutritional supplementation may be planned. The fasting period will also be as short as possible.

 

 

Care during and after surgery is optimized

 

The goal is three-fold;

  • To limit pain
  • To reduce the complication rate
  • To improve the patient autonomy

 

All cares are coordinated and chosen for their impact on those objectives.  The common base is low invasive surgery and specific anaesthetic agents.

 

Pain management is also a key point as it speeds the return to normal life.  A good result usually requires the combination of several techniques.

 

Drains and probes usage is rationalized and if needed, removed as early as possible.

 

Finally, latest scientific recommendations aiming at reducing infectious and thromboembolic complications are implemented.

 

 

The Patient is discharged based on predetermined criteria

 

 The doctor authorizes the Patient to go home based on the compliance with predetermined physiologic criteria (blood pressure, resumed bowel mobility…) and surgery-specific criteria (pain, limb flexion…).

 

 

What are the benefits in comparison with traditional practices?

  1. The post surgery complication rate is reduced 

This risk’s decrease is well established, specifically for colon surgery (up until 45 %!). It can be explained by multiple reasons. First of all, it is a more secure medicine, each care being planed on evidence-based medicine.  In addition the patient does not stay as long as usual at the hospital, therefore reducing the risk to catch an infection.  Whatever the surgery type, the mortality or rehospitalisation rate is equivalent after a traditional or Enhanced Recovery pathway.

 

  1. The Patient actively contributes to his recovery

 

  1. The Patient goes back home faster after surgery and is more confident in his abilities. In reality, it means a shorter stay from 25 to 50% for a specific surgery and patients’ profile.

Published studies show that Patients’ satisfaction is equivalent, if not higher after an Enhanced Recovery program, compared to traditional surgery.

 

 

What are the risks?

There are no increased or specific risks that have been identified; moreover, various studies on specific surgeries show a significant lower risk of complication for the patient.  The patient is well informed all along his pathway and on his return home.  He has been explained how to react in case he is anxious or feels he should contact a professional. If need be, he can call the team who has taken care of him while at the hospital.

 

 

You can watch a video on ERAS with English subtitles by cliking on the YouTube logo below :