الفهرس 
Anatomy of the AbdomenOnly 14 pages are availabe for public view
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Abstract
Enhanced Recovery After Surgery also known as ERAS, is a global initiative within the field of surgery that aims to improve the quality of care provided to patients before, during, and after their surgical procedures. While ERAS has demonstrated significant improvements in clinical outcomes and cost reduction across various surgical specialties, there remain areas of potential exploration and challenges that warrant further discussion.
Inadequate pain management, intestinal dysfunction, and immobilization have been recognized as the main factors delaying postoperative recovery in patients subjected to major abdominal surgery.
The concept of fast-track surgery, or ERAS was initially developed by Professor Henrik Kehlet in the mid-1990s, specifically for individuals undergoing colorectal surgery. This approach resulted in a significant reduction in the length of postoperative hospital stays. Subsequently, the ERAS Society was established in 2010, and guidelines have been released for different surgical procedures, including colorectal surgery, bariatric surgery, gastrectomy, liver surgery, and gynecologic oncology.
Implementing the ERAS process requires a collaborative team consisting of surgeons, an ERAS coordinator (often a physician assistant or nurse), anesthetists, and personnel from departments responsible for the care of surgical patients. Various components of ERAS care, such as the adoption of minimally invasive surgical techniques and the avoidance of fasting, aim to minimize the body’s stress response to surgery and maintain homeostasis. This approach helps prevent significant catabolism and the subsequent depletion of the patient’s body protein, strength, and overall function.
The fundamental principles of ERAS encompass several key elements. These include comprehensive preoperative counseling, elimination of bowel preparation, avoidance of sedative premedication, absence of preoperative fasting, consumption of preoperative carbohydrates, personalized anesthesiology, controlled administration of intravenous fluids during the perioperative period, non-opioid pain management, selective use of drains and nasogastric tubes, early initiation of postoperative nutrition, prompt removal of the urinary catheter, and early mobilization.
The aim of the study was to investigate the impact of enhanced recovery after surgery (ERAS) protocols on quality of life and patient satisfaction after elective abdominal surgeries. This randomized controlled trial included 100 patients selected from attendee of General Surgery clinics. Samples were collected by the systematic random method. The study protocol was approved by the Local Ethics Committee, and written informed consent was obtained.
The study compares two groups in terms of various parameters. Both groups were similar in terms of age, gender, BMI, and comorbidities. There were no significant differences in the duration of the operation or the amount of blood loss during the operation between the two groups. However, there was a significant difference in the number of drains used. The time of post-operative bowel movement did not differ significantly between the groups. There was a significant difference in the duration of hospital stay, with the traditional group staying longer than the ERAS group. Additionally, there were significant differences in the administration and types of postoperative analgesics between the two groups. Pain Visual analog scale scores differed significantly on the first day post-operative but not on the following three days. However, there was no significant difference in post-operative quality of life between the two groups.
ERAS is associated with less post-operative pain and hospital stay after surgery compared to traditional protocols. ERAS programs have proven to be effective, providing strong evidence for their expanded implementation in perioperative care for abdominal surgery.