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Clin Colon Rectal Surg 2019; 32(01): 075-081
DOI: 10.1055/s-0038-1673357
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Enhanced Recovery After Surgery Interactive Audit System: 10 Years' Experience with an International Web-Based Clinical and Research Perioperative Care Database

Andrew Currie
1   Department of Surgery, St Mark's Hospital, Harrow, United Kingdom
,
Mattias Soop
2   Department of Surgery, University of Manchester, Manchester, United Kingdom
3   Department of Surgery, Salford Royal Hospital, Manchester, United Kingdom
,
Nicolas Demartines
4   Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland
,
Kenneth Fearon
5   Department of Surgery, University of Edinburgh and Colorectal Unit, Western General Hospital, Edinburgh, United Kingdom
,
Robin Kennedy
1   Department of Surgery, St Mark's Hospital, Harrow, United Kingdom
6   Department of Surgery and Cancer, Imperial College London, London, United Kingdom
,
Olle Ljungqvist
7   Department of Surgery, Örebro University Hospital, Örebro, Sweden
› Author Affiliations
Further Information

Publication History

Publication Date:
08 January 2019 (online)

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Erratum to: Enhanced Recovery After Surgery Interactive Audit System: 10 Years' Experience with an International Web-Based Clinical and Research Perioperative Care DatabaseClin Colon Rectal Surg 2019; 32(01): e1-e1
DOI: 10.1055/s-0039-1678573

Abstract

The Enhanced Recovery After Surgery (ERAS) is a managed care program that has shown the ability to reduce complications following elective colorectal surgery. In 2006, the ERAS® Society developed the ERAS® Interactive Audit System (EIAS), which has allowed centers in over 20 countries to enter perioperative patient data to benchmark against international practice within the audit system and act as a stimulus for quality improvement. The de-identified patient data are coded in SQL (a relational database), stored on secure servers, and data governance aspects have been secured in all involved countries. A collaborative approach is undertaken within involved units toward research questions with published cohort data from the audit system having demonstrated the importance of overall compliance on improving patient outcomes and less cost of care. The EIAS has shown that collaborative clinical effort can drive quality improvement in a short time frame in an international context.

Keywords

surgery - audit - perioperative care - outcomes

Dedication

This article is dedicated to the memory of Professor Kenneth Fearon, who unfortunately passed away during the construction of this article. He was a founding member of the ERAS group and the ERAS Society and his commitment to improving patient outcomes after colorectal surgery has inspired the international evolution of the ERAS project.


 

  • References

  • 1 Fearon KC, Ljungqvist O, Von Meyenfeldt M. , et al. Enhanced Recovery After Surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr 2005; 24 (03) 466-477
    CrossrefPubMedGoogle Scholar
  • 2 Gustafsson UO, Hausel J, Thorell A, Ljungqvist O, Soop M, Nygren J. ; Enhanced Recovery After Surgery Study Group. Adherence to the Enhanced Recovery After Surgery protocol and outcomes after colorectal cancer surgery. Arch Surg 2011; 146 (05) 571-577
    CrossrefPubMedGoogle Scholar
  • 3 ERAS Compliance Group. The impact of enhanced recovery protocol compliance on elective colorectal cancer resection: results from an international registry. Ann Surg 2015; 261 (06) 1153-1159
    CrossrefPubMedGoogle Scholar
  • 4 Buzby GP, Williford WO, Peterson OL. , et al. A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr 1988; 47 (2, Suppl): 357-365
    CrossrefPubMedGoogle Scholar
  • 5 Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240 (02) 205-213
    CrossrefPubMedGoogle Scholar
  • 6 Hendry PO, Hausel J, Nygren J. , et al; Enhanced Recovery After Surgery Study Group. Determinants of outcome after colorectal resection within an enhanced recovery programme. Br J Surg 2009; 96 (02) 197-205
    CrossrefPubMedGoogle Scholar
  • 7 Slieker J, Frauche P, Jurt J. , et al. Enhanced recovery ERAS for elderly: a safe and beneficial pathway in colorectal surgery. Int J Colorectal Dis 2017; 32 (02) 215-221
    CrossrefPubMedGoogle Scholar
  • 8 Ahmed J, Khan S, Gatt M, Kallam R, MacFie J. Compliance with enhanced recovery programmes in elective colorectal surgery. Br J Surg 2010; 97 (05) 754-758
    CrossrefPubMedGoogle Scholar
  • 9 Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O. Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a retrospective cohort study. World J Surg 2016; 40 (07) 1741-1747
    CrossrefPubMedGoogle Scholar
  • 10 Khuri SF, Henderson WG, DePalma RG, Mosca C, Healey NA, Kumbhani DJ. ; Participants in the VA National Surgical Quality Improvement Program. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005; 242 (03) 326-341 , discussion 341–343
    CrossrefPubMedGoogle Scholar
  • 11 Nelson G, Kiyang LN, Crumley ET. , et al. Implementation of Enhanced Recovery After Surgery (ERAS) across a provincial healthcare system: The ERAS Alberta Colorectal Surgery Experience. World J Surg 2016; 40 (05) 1092-1103
    CrossrefPubMedGoogle Scholar
  • 12 Thanh NX, Chuck AW, Wasylak T. , et al. An economic evaluation of the Enhanced Recovery After Surgery (ERAS) multisite implementation program for colorectal surgery in Alberta. Can J Surg 2016; 59 (06) 415-421
    CrossrefPubMedGoogle Scholar
  • 13 Schell SF, Luke DA, Schooley MW. , et al. Public health program capacity for sustainability: a new framework. Implement Sci 2013; 8: 15
    CrossrefPubMedGoogle Scholar
  • 14 Martin D, Roulin D, Addor V, Blanc C, Demartines N, Hübner M. Enhanced recovery implementation in colorectal surgery-temporary or persistent improvement?. Langenbecks Arch Surg 2016; 401 (08) 1163-1169
    CrossrefPubMedGoogle Scholar
  • 15 Cakir H, van Stijn MF, Lopes Cardozo AM. , et al. Adherence to Enhanced Recovery After Surgery and length of stay after colonic resection. Colorectal Dis 2013; 15 (08) 1019-1025
    CrossrefPubMedGoogle Scholar
  • 16 Hübner M, Addor V, Slieker J. , et al. The impact of an enhanced recovery pathway on nursing workload: A retrospective cohort study. Int J Surg 2015; 24 (Pt A): 45-50
    CrossrefPubMedGoogle Scholar
  • 17 Horton R. Surgical research or comic opera: questions, but few answers. Lancet 1996; 347 (9007): 984-985
    CrossrefPubMedGoogle Scholar
  • 18 Basse L, Hjort Jakobsen D, Billesbølle P, Werner M, Kehlet H. A clinical pathway to accelerate recovery after colonic resection. Ann Surg 2000; 232 (01) 51-57
    CrossrefPubMedGoogle Scholar
  • 19 Bardram L, Funch-Jensen P, Kehlet H. Rapid rehabilitation in elderly patients after laparoscopic colonic resection. Br J Surg 2000; 87 (11) 1540-1545
    CrossrefPubMedGoogle Scholar
  • 20 Kennedy RH, Francis EA, Wharton R. , et al. Multicenter randomized controlled trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme: EnROL. J Clin Oncol 2014; 32 (17) 1804-1811
    CrossrefPubMedGoogle Scholar
  • 21 Vlug MS, Wind J, Hollmann MW. , et al; LAFA Study Group. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study). Ann Surg 2011; 254 (06) 868-875
    CrossrefPubMedGoogle Scholar
  • 22 McCulloch P, Altman DG, Campbell WB. , et al; Balliol Collaboration. No surgical innovation without evaluation: the IDEAL recommendations. Lancet 2009; 374 (9695): 1105-1112
    CrossrefPubMedGoogle Scholar