Enhanced recovery after surgery (ERAS) protocol implementation in open abdominal aortlc surgery: a comparattve retrospecïve single-center study ; Protocole de récupération améliorée après chirurgie (ERAS) mise en œuvre en chirurgie ouverte de l'aorte abdominale : une étude rétrospective comparative monocentrique

Introduction: open aortic surgery presents a complex and high-risk vascular surgery. Recently, the concept of Enhanced rehabilitation after surgery (ERAS) has received much attention as a multimodal approach to improve patient outcomes and recovery after surgery. However, their implementation and outcomes in aortic vascular surgery have not reached consensus and remain an area of ongoing research. Therefore, to provide the best care to patients, we studied the effect of implementing an ERAS procedure for open abdominal aortic aneurysm (AAA) surgery.Materials and methods: according to French ERAS recommendations, we created in November 2021 a local protocol and conducted an observational historical cohort study, in the vascular surgery unit from the University hospital of Nice, France, before and after our local ERAS protocol implementation. The 3 parts of the protocol (pre – per and postoperative periods) involved various healthcare disciplines and aimed to minimize surgical stress response, optimize pain management, facilitate early mobilization, and enhance postoperative functional recovery. The primary endpoint was a composite score of complications after surgery during hospitalization. Secondary endpoints were length of hospital stay (LOS) and length of intensive treatment unit (ITU) stay, acute renal failure, norepinephrine consumption, complications on epidural analgesia and medical complications 3 months aaer surgery.Results: from January 2022 to March 2023, all patients who were candidates for open abdominal aortic surgery at our department were enrolled in the ERAS protocol (n=27). Patients were compared to 64 patients who underwent open abdominal surgery before implementation of ERAS protocol following the same criteria between January 2019 and March 2023. We found significantly less postoperative medical complications (p = 0.0ti) and less day 90 complications (p=0.03) in the ERAS group compared to patients without ERAS protocol, Earlier bowel function recovery was found in ERAS group compared to the ...