A pilot study of the ERAS (Enhanced Recovery After Surgery) protocol in aortic surgery

Abstract Aim of the study To test the outcomes of the ERAS (Enhanced Recovery After Surgery) protocol in patients undergoing open repair for abdominal aortic aneurysm (AAA) and to compare them with those obtained in patients undergoing endovascular aneurysm repair (EVAR) and with standard AAA open repair in a prospective, single centre pilot study. Material and Methods Between June and December 2019, all patients candidate to open AAA at our department were enrolled in the ERAVS protocol (ERAVS group, 17 patients). In the same period of time, 18 patients underwent EVAR (EVAR group). The historical control group of patients treated with standard open AAA repair included 32 patients operated on in the six months before the beginning of the study (OR group). The three groups were compared in an “on-treatment” basis (both prospectively for ERAVS and EVAR groups) and retrospectively (for OR group) in terms of time to discharge (TTD), time to resumption of oral intake, time to ambulation, resumption of bowel function and postoperative pain. Comparisons were performed through the use of one-way ANOVA test, Tukey post-hoc test for quantitative data and χ2 test for qualitative data. Results The ERAVS protocol was successfully applied in all but one patient (feasibility rate 94%). The mean TTD values were 5.1 days in the ERAVS group, 3.5 days in EVAR group and 8.4 days in the OR group (p Conclusions In our early experience, the ERAVS protocol appeared to be effective in reducing TTD and improving the postoperative items in comparison to OR, without significant differences with EVAR patients.