Usefulness of an enhanced recovery after surgery protocol for perioperative management following open repair of an abdominal aortic aneurysm.
OBJECTIVE
To achieve early recovery and early discharge from the hospital by applying an enhanced recovery after surgery (ERAS) protocol, which is mainly used with colonic surgery, for the perioperative management of open AAA surgery.


METHODS
One hundred twenty-seven open AAA surgery cases successfully carried out between 2003 and 2011 were included in this study. The ERAS protocol was used for the cases from April 2008 onward, and we performed a comparison of the conventionally treated cases with ERAS cases regarding the start of postoperative oral consumption, the postoperative hospital stay, and hospitalization medical costs.


RESULTS
The time to restarting oral consumption and the postoperative hospital stay were significantly shorter for the ERAS group (n = 52) compared to the conventionally managed group (n = 75); with values of 59 ± 15 and 93 ± 25 h (p = 0.021), 9 ± 3 and 16 ± 5 days (p = 0.001), respectively. The medical costs for the ERAS group were 92 % of the costs of the conventionally managed group.


CONCLUSIONS
Use of the ERAS protocol for the perioperative management of open AAA surgery shortened the time before recommencing oral consumption, the postoperative hospital stay, and reduced the medical costs compared to the conventional approach.
Department of Cardiovascular Surgery, Tokyo Women's Medical University, Medical Center East, Nishiogu 2-1-10, Arakawa-Ku, Tokyo 116-8567, Japan. wataru0812_drt@ybb.ne.jp
Wataru
W
Tatsuishi
Takayuki
T
Kohri
Kojiro
K
Kodera
Ryota
R
Asano
Go
G
Kataoka
Sayaka
S
Kubota
Kiyoharu
K
Nakano
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000191:economics* / Q000534:rehabilitation / Q000601:surgery*; D002985:Clinical Protocols; D004434:Early Ambulation / Q000191:economics; D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D011446:Prospective Studies; D014041:Tokyo; D016896:Treatment Outcome