title: Impact of weekday surgery on application of enhanced recovery pathway: a retrospective cohort study.
abstract: To compare the enhanced recovery after surgery (ERAS) protocol compliance and clinical outcomes depending on the weekday of surgery.
  
  
  
  Cohort of consecutive non-selected patients undergoing elective colorectal surgery from January 2012 to March 2015. This retrospective analysis of our prospective database compared patients operated early in the week (Monday and Tuesday) with patients operated in the second half (late: Thursday, Friday).
  
  
  
  Compliance with the ERAS protocol, functional recovery, complications and length of stay.
  
  
  
  Demographic and surgical details were similar between the early (n=352) and late groups (n=204). Overall compliance with the ERAS protocol was 78% vs 76% for the early and late groups, respectively (p=0.009). Significant differences were notably prolonged urinary drainage and intravenous fluid infusion in the late group. Complication rates and length of stay, however, were not different between surgery on Monday or Tuesday and surgery on Thursday or Friday.
  
  
  
  Application of the ERAS protocol showed only minor differences for patients operated on early or late during the week, and clinical outcomes were similar. A fully implemented ERAS programme appears to work also over the weekend.
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Benoît
authors.initials: B
authors.lastname: Romain
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Fabian
authors.initials: F
authors.lastname: Grass
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Valérie
authors.initials: V
authors.lastname: Addor
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Hübner
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D015331:Cohort Studies; D015179:Colorectal Neoplasms / Q000601:surgery*; D003107:Colorectal Surgery / Q000379:methods*; D003695:Delivery of Health Care; D013505:Digestive System Surgical Procedures; D017558:Elective Surgical Procedures; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007420:Intestine, Large / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D012189:Retrospective Studies
keywords: ERAS; complications; enhanced recovery; weekdays