Attitudes towards Enhanced Recovery after Surgery (ERAS) interventions in colorectal surgery: nationwide survey of Australia and New Zealand colorectal surgeons - Report - MDSpire
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Attitudes towards Enhanced Recovery after Surgery (ERAS) interventions in colorectal surgery: nationwide survey of Australia and New Zealand colorectal surgeons
Clinical Report: ERAS Protocol Perceptions Among Colorectal Surgeons in Australia/NZ
Overview
A survey of 95 colorectal surgeons in Australia and New Zealand evaluated attitudes toward 18 ERAS interventions. Preoperative iron infusion, minimally invasive surgery, and early catheter removal ranked highest in perceived effectiveness for improving short-term outcomes.
Background
Enhanced Recovery after Surgery (ERAS) programs improve morbidity, recovery, and hospital length of stay in colorectal surgery. While American and European ERAS guidelines exist, Australia and New Zealand lack local standardized protocols. Compliance with ERAS elements correlates with better outcomes, but variation exists in implementation and surgeon perspectives on specific interventions.
Data Highlights
ERAS Intervention
Weighted Mean
IRT Score (95% CI)
Preoperative iron infusion
7.84
7.82 (6.01–9.16)
Minimally invasive surgery
7.78
7.77 (5.96–9.07)
Early in-dwelling catheter removal
7.65
7.69 (5.83–9.01)
Preoperative smoking cessation
7.51
7.68 (5.49–9.18)
Preoperative counselling
7.47
7.44 (5.58–8.88)
Avoiding drains in colon surgery
7.24
7.37 (5.17–8.95)
Avoiding nasogastric tubes
7.21
7.29 (5.32–8.80)
Early drain removal in rectal surgery
5.71
5.5+ (exact CI not provided)
Key Findings
Preoperative iron infusion was rated as the most effective ERAS intervention for improving short-term outcomes.
Minimally invasive surgery and early removal of urinary catheters were highly valued by surgeons.
Preoperative smoking cessation and counselling were also ranked among the top interventions.
Surgeons favored avoiding drains in colon surgery and nasogastric tubes postoperatively.
There was significant variability in surgeon attitudes toward other ERAS elements such as mechanical bowel preparation and oral antibiotics.
Clinical Implications
These findings highlight key ERAS components prioritized by colorectal surgeons in Australia and New Zealand, supporting targeted implementation of interventions like preoperative iron correction and minimally invasive techniques. Understanding surgeon perspectives can guide development of localized ERAS protocols to improve compliance and patient outcomes.
Conclusion
The survey identifies consensus on several important ERAS interventions among colorectal surgeons in Australia and New Zealand, providing a foundation for establishing best practice guidelines tailored to the region.
References
Perceptions of Enhanced Recovery after Surgery (ERAS) Protocols among Colorectal Surgeons: A Nationwide Survey in Australia and New Zealand
by James Wei Tatt Toh, Geoffrey Peter Collins, Nimalan Pathma-Nathan, Toufic El-Khoury, Alexander Engel, Stephen Smith, Arthur Richardson, Grahame Ctercteko
