title: Enhanced postoperative recovery pathways in emergency surgery: a randomised controlled clinical trial.
abstract: BACKGROUND
  Enhanced recovery pathways are now widely used in elective surgical procedures. The feasibility of enhanced postoperative recovery pathways in emergency surgery for perforated peptic ulcer disease was investigated in this randomized controlled clinical trial.
  
  
  METHODS
  Patients with perforated peptic ulcer disease who underwent laparoscopic repair were randomized into 2 groups. Group 1 patients were managed with standard postoperative care and group 2 patients with enhanced postoperative recovery pathways. The primary endpoints were the length of hospital stay and morbidity and mortality.
  
  
  RESULTS
  Forty-seven patients were included in the study. There were 26 patients in group 1 and 21 in group 2. There were no significant differences in the morbidity and mortality rates, whereas the length of hospital stay was significantly shorter in group 2.
  
  
  CONCLUSIONS
  The application of enhanced postoperative recovery pathways in selected patients with perforated peptic ulcer disease who undergo laparoscopic Graham patch repair seems feasible.
authors.affiliation: General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Electronic address: gonencmed@hotmail.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Gonenc
authors.affiliation: General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet Cem
authors.initials: AC
authors.lastname: Dural
authors.affiliation: General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ferhat
authors.initials: F
authors.lastname: Celik
authors.affiliation: General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Cevher
authors.initials: C
authors.lastname: Akarsu
authors.affiliation: General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Kocatas
authors.affiliation: General Surgery Clinics, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa Uygar
authors.initials: MU
authors.lastname: Kalayci
authors.affiliation: Administrator, Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
authors.forename: Yasar
authors.initials: Y
authors.lastname: Dogan
authors.affiliation: Sisli Etfal Training and Research Hospital, Istanbul, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Alis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000401:mortality / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000401:mortality; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Enhanced recovery; Fast-track surgery; Nasogastric tube; Peptic ulcer disease; Perforated ulcer