Evaluation of enhanced recovery after surgery program components implemented in laparoscopic appendectomy: prospective randomized clinical study

Abstract

Background Laparoscopic appendectomy (LA) is a widely used surgical procedure. Patients often suffer from considerable postoperative pain and indigestion, which prolongs their in-hospital stay. Almost 10% of patients develop postoperative complications. The enhanced recovery after surgery (ERAS) program has proven its efficacy in elective surgery and could hypothetically improve LA outcomes. Currently, there is no ERAS program for LA. Methods A modified ERAS (mERAS) protocol was studied in a prospective, randomized nonblinded clinical trial. The mERAS group consisted of 50 patients; the control group, of 54 patients. The mERAS protocol included a patient information brochure; minimizing drain use; local anesthesia; low-pressure pneumoperitoneum; early mobilization and oral diet. The primary outcome was postoperative length of stay (pLOS). Results Modified protocol reduced median pLOS to 1.25 days vs 2 days in the controls (p < 0.0001). Twenty-one (42%) mERAS patients and 4 (7.4%) controls were discharged within 24 h (p < 0.001) after surgery; 0 readmissions were reported. Postoperative pain intensity assessed on the visual analogue scale was significantly lower in the mERAS group [mERAS vs control 0

Rapid rehabilitation effect on complications, wound infection, anastomotic leak, obstruction, and hospital re‐admission for gastrointestinal surgery subjects: A meta‐analysis

“…A total of 1021 distinctive studies were found, of which 31 studies (between 2003 and 2021) satisfied the inclusion criteria and were comprised in the study 14‐44 . The 32 studies included 4448 subjects with gastrointestinal surgery at the start of the study: 2242 of them were provided with rapid rehabilitation and 2206 were standard care.…”

“…This meta‐analysis study based on 31 studies included 4448 subjects with gastrointestinal surgery at the start of the study: 2242 of them were provided with rapid rehabilitation and 2206 were standard care 14‐44 . Rapid rehabilitation had significantly lower complications and wound infection compared with standard care in subjects with gastrointestinal surgery.…”

Study of Heel Pain in Rheumatic Diseases

“…A periappendicular abscess is a difficult procedure that should be conducted during the day. Most people who have undergone a non-perforated appendix ectomy may go home within 23 hours after the operation (11) . In this study, we compared laparoscopic and open surgery for suspected appendicitis.…”

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

“…Several studies demonstrated laparoscopic appendectomy for nonperforated appendicitis to be safely performed as fast-track protocols for children [4][5][6] and adults [7]. Recently, randomized controlled trials of laparoscopic appendectomy in appendicitis was conducted [8,9] and the ERAS program for laparoscopic appendectomy has advantages over the traditional approach.…”