Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.

An international assessment of the adoption of enhanced recovery after surgery (ERAS®) principles across colorectal units in 2019–2020

Carcoforo P.
Membro del Collaboration Group
;
Feo C.
Membro del Collaboration Group
;
2021

Abstract

Aim: The Enhanced Recovery After Surgery (ERAS®) Society guidelines aim to standardize perioperative care in colorectal surgery via 25 principles. We aimed to assess the variation in uptake of these principles across an international network of colorectal units. Method: An online survey was circulated amongst European Society of Coloproctology members in 2019–2020. For each ERAS principle, respondents were asked to score how frequently the principle was implemented in their hospital, from 1 (‘rarely’) to 4 (‘always’). Respondents were also asked to recall whether practice had changed since 2017. Subgroup analyses based on hospital characteristics were conducted. Results: Of hospitals approached, 58% responded to the survey (195/335), with 296 individual responses (multiple responses were received from some hospitals). The majority were European (163/195, 83.6%). Overall, respondents indicated they ‘most often’ or ‘always’ adhered to most individual ERAS principles (18/25, 72%). Variability in the uptake of principles was reported, with universal uptake of some principles (e.g., prophylactic antibiotics; early mobilization) and inconsistency from ‘rarely’ to ‘always’ in others (e.g., no nasogastric intubation; no preoperative fasting and carbohydrate drinks). In alignment with 2018 ERAS guideline updates, adherence to principles for prehabilitation, managing anaemia and postoperative nutrition appears to have increased since 2017. Conclusions: Uptake of ERAS principles varied across hospitals, and not all 25 principles were equally adhered to. Whilst some principles exhibited a high level of acceptance, others had a wide variability in uptake indicative of controversy or barriers to uptake. Further research into specific principles is required to improve ERAS implementation.
2021
Pinkney, T. D.; Taylor, H.; Tong, C.; Schmitz, N. -D.; Morton, D. G.; Bhangu, A.; Blackwell, S.; Dardanov, D.; Dulskas, A.; Gallo, G.; Glasbey, J.; Keatley, J.; Knowles, C.; Li, Y. E.; Mccourt, V.; Minaya-Bravo, A.; Neary, P.; Nepogodiev, D.; Pata, F.; Pellino, G.; Sivrikoz, E.; van Ramshorst, G.; Zmora, O.; Perry, R.; Magill, E. L.; Abdalkoddus, M.; Abelevich, A.; Abraham, S.; Abraham-Nordling, M.; Adamina, M.; Agalar, C.; Agresta, F.; Ahallat, M.; Ahmad, N.; Aiupov, R.; Akca, O.; Aleksic, A.; Aleotti, F.; Alias, D.; Alonso, J.; Alonso Goncalves, S.; Alonso Martin, J.; Alonso Poza, A.; Alonso-Hernandez, N.; Alos Company, R.; Al-Saeedi, M.; Alvarez-Laso, C.; Alvarez-Gallego, M.; Amanatidis, T.; Americano, M.; Amorim, E.; Anandan, L.; Anania, G.; Ancans, G.; Andreev, P.; Andrejevic, P.; Antonacci, N.; Anwer, M.; Aonzo, P.; Arencibia, B.; Argeny, S.; Arieli, H.; Arnold, S.; Ashraf, M.; Aslam, M.; Atanasov, B.; Atif, M.; Atladottir, J.; Avital, S.; Awny, S.; Aytac, B.; Azahr, N.; Aznar-Puig, S.; Bailey, S.; Balalis, D.; Baldi, C.; Baldonedo, R.; Balducci, G.; Balestra, F.; Balestri, R.; Balfour, A.; Baloyiannis, I.; Banky, B.; Baral, J.; Baranyai, Z.; Barbashinov, N.; Bargallo, J.; Barisic, G.; Barugola, G.; Batashki, I.; Battersby, N.; Belev, N.; Belli, A.; Beltran de Heredia, J.; Bemelman, W.; Benavides Buleje, J.; Benckert, A.; Bernal-Sprekelsen, J.; Bertocchi, E.; Beuran, M.; Bhan, C.; Bianco, F.; Bilali, S.; Bilali, V.; Bintintan, V.; Birindelli, A.; Birindelli, A.; Birsan, T.; Blanco Antona, F.; Blas, J.; Blasco-Segura, T.; Blom, R.; Bocchetti, T.; Boerma, E.; Bogdan, M.; Boland, M.; Bomans, B.; Borda, N.; Bowen, M.; Bradulskis, S.; Branagan, G.; Brankovic, B.; Brenna, M.; Brewer, H.; Broadhurst, J.; Bronder, C.; Brouwer, R.; Buccianti, P.; Buchs, N.; Buchwald, P.; Bugatti, A.; Bui, A.; Burcos, T.; Buskens, C.; Bustamante, C.; Caceres, N.; Cagigas Fernandez, C.; Calero-Lillo, A.; Camps, I.; Canda, A.; Caravaca-Garcia, I.; Carballo, F.; Carcoforo, P.; Carlander, J.; Carlos, S.; Caro, A.; Carpelan, A.; Carrasco Prats, M.; Carrillo Lopez, M.; Carvello, M.; Casal, E.; Casoni Pattacini, G.; Castellvi Valls, J.; Castillo Diego, J.; Cavallesco, G.; Cavenaile, V.; Cayetano, L.; Ceccotti, A.; Cervera-Aldama, J.; Chabok, A.; Chafai, N.; Chandrasinghe, P.; Chandratreya, N.; Chaudhri, S.; Chaudhry, Z.; Cherdancev, D.; 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El Sorogy, M.; Elgeidie, A.; Elhemaly, M.; El-Hussuna, A.; Ellul, S.; Elmore, U.; Elnakeeb, A.; Elrefai, M.; Emile, S.; Enrriquez-Navascues, J.; Epstein, J.; Escartin, J.; Escola, D.; Escuder, J.; Espin, E.; Espina, B.; Estefania, D.; Etienne, J.; Fabbri, S.; Falato, A.; Fares, R.; Farina, P.; Farkasova, M.; Farres, R.; Fasolini, F.; Fatayer, T.; Febles, G.; Feliu, F.; Feo, C.; Feoktistov, D.; Fernandez, F.; Fernandez Isart, M.; Fernando, J.; Ferreira, G.; Ferrer, R.; Ferreras Garcia, C.; Ferri, M.; Figueiredo, N.; Finotti, E.; Fitzgerald, J.; Flateh Backe, I.; Flor-Lorente, B.; Forero-Torres, A.; Foschi, D.; Francart, D.; Francois, Y.; Frasson, M.; Freil-Lanter, C.; Frois Borges, M.; Fuzun, M.; Gala, T.; Galleano, R.; Galvez, P.; Galvez Saldana, A.; Gamundi Cuesta, M.; Garcia Cabrera, A.; Garcia Egea, J.; Garcia Olmo, D.; Garcia-Gonzalez, J.; Garcia-Granero, A.; Garcia-Granero, E.; Garcia-Septiem, J.; Gardea, A.; Garipov, M.; Gefen, R.; Geraghty, A.; Gerkis, S.; Germanos, S.; Ghaffari, S.; 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Kaul, N.; Kefalou, E.; Keijzers, M.; Kelly, M.; Kenic, M.; Kennelly, R.; Khan, J.; Khan, M.; Kho, H.; Kinas, V.; Knight, J.; Kocian, P.; Koeter, T.; Kokobelyan, A.; Konsten, J.; Koolen, L.; Kosir, J.; Kostic, I.; Krdzic, I.; Kreisler Moreno, E.; Krivokapic, Z.; Krstev, P.; Krsul, D.; Kumarasinghe, N.; La Torre, F.; Labarga, F.; Ladra, M.; Lage Laredo, A.; Lahodzich, N.; Lai, C.; Lakkis, Z.; Lal, R.; Lamas, S.; Lang, T.; Latkauskas, T.; Lawes, D.; Lazar, G.; Lebedev, K.; Lebedeva, M.; Lefevre, J.; Lekic Vitlov, V.; Lemma, M.; Leo, C.; Leon, C.; Leventoglu, S.; Levy, B.; Li, L.; Licari, L.; Lizdenis, P.; Loftas, P.; Longhi, M.; Longstaff, L.; Lopez Dominguez, J.; Lopez-Lara, M.; Lora, P.; Lorenzon, L.; Lorusso, D.; Lozev, I.; Lozoya Trujillo, R.; Lukic, D.; Lunins, R.; Luzan, R.; Luzzi, A.; Maderuelo, V.; Madsboll, T.; Mahotin, D.; Majbar, M.; Makhmudov, A.; Malik, K.; Maly, O.; Mamaloudis, I.; Mamedli, Z.; Manatakis, D.; Mandi, D.; Mangell, P.; Marharint, T.; Mariani, N.; Maric, B.; Marimuthu, K.; Marinello, F.; Marino, F.; Markiewicz, S.; Markovic, V.; Marom, G.; Maroni, N.; Maroulis, I.; Marsanic, P.; Marsman, H.; Martens, M.; Marti, M.; Martinek, L.; Martinez, S.; Martinez, D.; Martinez Manzano, A.; Martins, R.; Maslyankov, S.; Mcardle, K.; Mcdermott, F.; Mege, D.; Mehraj, A.; Mehta, A.; Mendrila, D.; Menendez, P.; Mercantini, P.; Metwally, I.; Mikalauskas, S.; Mikalauskas, S.; Millan, M.; Minaya-Bravo, A.; Mingoli, A.; Mirshekar-Syahkal, B.; Moggia, E.; Mohan, S.; Moller, P.; Mompart Garcia, S.; Monami, B.; Moniz Pereira, P.; Montroni, I.; Morel, P.; Moshev, B.; Mostovoy, E.; Mothe, S.; Mukhtar, H.; Muller, P.; Munch, S.; Munoz Camarena, J.; Munoz-Collado, S.; Muratore, A.; Muscara, F.; Muysoms, F.; Myrelid, P.; N. Lah, N.; Nail, S.; Narayanan, A.; Nastos, K.; Negoi, I.; Nesbakken, A.; Nestler, G.; Nestorovic, M.; Nesytykh, A.; Newton, K.; Ng, Y.; Ngu, J.; Nguyen, B.; Nijs, Y.; Nikberg, M.; Nimmersgern, T.; Nogues, E.; Norcic, G.; Nutautiene, V.; Nygren, J.; O'Brien, J.; Ochogavia Segui, A.; O'Kelly, J.; Oliveira-Cunha, M.; Omar, W.; Omar, G.; Onishchenko, S.; Onody, P.; Opocher, E.; Orhalmi, J.; Oshowo, A.; Otero, J.; Ozgen, U.; Pace, K.; Padin, H.; Papaconstantinou, I.; Papadopoulos, A.; Papadopoulos, G.; Papandrea, M.; Paral, J.; Parc, Y.; Paredes, J.; Parmar, M.; Parra Banos, P.; Parray, F.; Pascual Damieta, M.; Pascual Miguelanez, I.; Passot, G.; Pastor, C.; Paszt, A.; Patel, P.; Paterson, H.; Patron Uriburu, J.; Paulos, A.; Pavlov, V.; Pcolkins, A.; Pecic, V.; Pena Ros, E.; Penkov, R.; Pera Roman, M.; Perunicic, V.; Pery, R.; Petrovic, D.; Pezzolla, F.; Photi, E.; Pikarsky, A.; Piramanayagam, B.; Pisani Ceretti, A.; Planellas, P.; Platt, E.; Pletinckx, P.; Podda, M.; Poskus, T.; Poskus, T.; Poskus, E.; Poskus, E.; Pozdnyakov, A.; Pravosudov, I.; Previsic, A.; Prieto, D.; Prochazka, V.; Prodan, A.; Proud, D.; Psaila, J.; Psaras, G.; Pulighe, F.; Pullig, F.; Qureshi, M.; Rachadell, J.; Radovanovic, Z.; Radovanovic, D.; Raguan, B.; Rahman, M.; Raiss, M.; Ramirez Faraco, M.; Ramos, J.; Ramos-Prada, J.; Rantala, A.; Rao, M.; Rasulov, A.; Ratnatunga, K.; Raymond, T.; Refky, B.; Reggiani, L.; Regusci, L.; Reyes Diaz, M.; Richardson, J.; Richiteanu, G.; Rios, A.; Ris, F.; Rodriguez Garcia, P.; Roffi, N.; Romairone, E.; Romano, G.; Romero, I.; Romero de Diego, A.; Romero-Simo, M.; Roque, C.; Rosati, R.; Rossi, B.; Rossi, E.; Rossini, R.; Ruano, A.; Rubbini, M.; Rubio-Perez, I.; Ruffo, G.; Ruiz, H.; Ruiz Carmona, M.; Ryska, O.; Sabia, D.; Sacchi, M.; Sacco, R.; Sakr, A.; Saladzinskas, Z.; Salamone, G.; Salomon, M.; Salvans Ruiz, S.; Sammarco, G.; Sampietro, G.; Samsonov, D.; Samsonyuk, V.; Sanchez, J.; Sanchez Romero, A.; Sanchez-Guillen, L.; Santak, G.; Santamaria-Olabarrieta, M.; Santos, J.; Saraceno, F.; Saralegui, Y.; Sarici, I.; Savino, G.; Scabini, S.; Schafli, J.; Schiltz, B.; Schofield, A.; Schon, M.; Scurtu, R.; Segalini, E.; Segelman, J.; Segura-Sampedro, J.; Seicean, R.; Sekulic, A.; Selniahina, L.; Seretis, F.; Serrano Paz, P.; Shaikh, I.; Shalaby, M.; Shams, N.; Sharma, A.; Sharma, G.; Shukla, A.; Shussman, N.; Shweejawee, Z.; Sielezneff, I.; Sigurdsson, H.; Sileri, P.; Silva, M.; Simcikas, D.; Simoes, J.; Simonka, Z.; Singh, B.; Sivins, A.; Skroubis, G.; Skull, A.; Slavchev, M.; Slavin, M.; Smart, N.; Smart, C.; Smart, P.; Smedh, K.; Smolarek, S.; Sokmen, S.; Sokolov, M.; Solana Bueno, A.; Solar, L.; Sorrentino, L.; Sotona, O.; Spacca, D.; Spinelli, A.; Stanojevic, G.; Stearns, A.; Stefan, S.; Stift, A.; Stijns, J.; Stoyanov, V.; Straarup, D.; Strupas, K.; Strupas, K.; Stubbs, B.; Subocius, A.; Sudlow, A.; Suero, C.; Sungurtekin, U.; Svagzdys, S.; Syk, I.; Tamelis, A.; Tamhane, R.; Tamini, N.; Tamosiunas, A.; Tanis, P.; Tarasov, N.; Tate, S.; Tennakoon, A.; Teo, N.; Terzi, C.; Tezas, S.; Thabet, W.; Tham, J.; Thavanesan, N.; Theodosopoulos, T.; Thomas, W.; Tiret, E.; Tiselius, C.; Todorov, G.; Tomazic, A.; Tomulescu, V.; Torkington, J.; Totis, M.; Trostchansky, I.; Truan, N.; Tulchinsky, H.; Tutino, R.; Tzivanakis, A.; Tzovaras, G.; Ugolini, G.; Unger, L.; Upanishad, I.; Urbani, L.; Uth Ovesen, A.; Vaizey, C.; Vallribera, F.; Valsdottir, E.; Valverde, I.; Valverde-Sintas, J.; Van Belle, K.; Van Cleven, S.; van Hagen, P.; van Loon, Y.; van Ruler, O.; Van Wijck, K.; Varabei, A.; Varcada, M.; Varpe, P.; Vartic, M.; Velchuru, V.; Vencius, J.; Venskutonis, D.; Vercher, D.; Vermaas, M.; Vertruyen, M.; Verza, L.; Vescio, G.; Vezakis, A.; Vieira, P.; Vignali, A.; Vigorita, V.; Vila Tura, M.; Vinson-Bonnet, B.; Viso Pons, L.; Voloshin, S.; Voronin, Y.; Vukusic, L.; Wang, X.; Wang, J.; Wani, R.; Warusavitarne, J.; Wasserberg, N.; Weerts, J.; Weiss, D.; Weizman, A.; Westerduin, E.; Wheat, J.; White, I.; Wik, T.; Wilson, J.; Winter, D.; Wolthuis, A.; Wong, M.; Yahia, S.; Yamamoto, T.; Yanishev, A.; Yao, C.; Yildiz, A.; Yuksel, O.; Zain, Z.; Zakaria, A.; Zakaria, Z.; Zampitis, N.; Zarand, A.; Zarco-Pleguezuelos, A.; Zattoni, D.; Zelic, M.; Zeromskas, P.; Zhuravlev, A.; Zimmerman, D.; Zuhdy, M.; Zukanovic, G.
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