title: Enhanced Recovery after Surgery in a Single High-Volume Surgical Oncology Unit: Details Matter.
abstract: Benefits of ERAS protocol have been well documented; however, it is unclear whether the improvement stems from the protocol or shifts in expectations. Interdisciplinary educational seminars were conducted for all health professionals. However, one test surgeon adopted the protocol. 394 patients undergoing elective abdominal surgery from June 2013 to April 2015 with a median age of 63 years were included. The implementation of ERAS protocol resulted in a decrease in the length of stay (LOS) and mortality, whereas the difference in cost was found to be insignificant. For the test surgeon, ERAS was associated with decreased LOS, cost, and mortality. For the control providers, the LOS, cost, mortality, readmission rates, and complications remained similar both before and after the implementation of ERAS. An ERAS protocol on the single high-volume surgical unit decreased the cost, LOS, and mortality.
authors.affiliation: East Carolina University Brody School of Medicine, Division of Surgical Oncology, Greenville, NC 27834, USA; East Carolina University Brody School of Medicine, Department of Surgery, Greenville, NC 27834, USA.
authors.forename: Timothy L
authors.identifier: 0000-0001-7350-1269
authors.initials: TL
authors.lastname: Fitzgerald
authors.affiliation: East Carolina University Brody School of Medicine, Division of Surgical Oncology, Greenville, NC 27834, USA; East Carolina University Brody School of Medicine, Department of Surgery, Greenville, NC 27834, USA.
authors.forename: Catalina
authors.identifier: 0000-0002-5211-6115
authors.initials: C
authors.lastname: Mosquera
authors.affiliation: East Carolina University Brody School of Medicine, Division of Surgical Oncology, Greenville, NC 27834, USA.
authors.forename: Nicholas J
authors.identifier: 0000-0003-1246-5641
authors.initials: NJ
authors.lastname: Koutlas
authors.affiliation: East Carolina University Brody School of Medicine, Division of Surgical Oncology, Greenville, NC 27834, USA; East Carolina University Brody School of Medicine, Department of Surgery, Greenville, NC 27834, USA.
authors.forename: Nasreen A
authors.initials: NA
authors.lastname: Vohra
authors.affiliation: Vidant Medical Centre, Division of Dietetics and Nutrition, Greenville, NC 27834, USA.
authors.forename: Kimberly V
authors.initials: KV
authors.lastname: Edwards
authors.affiliation: East Carolina University Brody School of Medicine, Division of Surgical Oncology, Greenville, NC 27834, USA; East Carolina University Brody School of Medicine, Department of Surgery, Greenville, NC 27834, USA.
authors.forename: Emmanuel E
authors.initials: EE
authors.lastname: Zervos