Complications and length of stay after Enhanced Recovery After Surgery (ERAS) compared to conventional care in colorectal cancer patients in Northern Italy

Massimiliano Fabozzi¹Federica Mereu¹Francesco Marinelli²Isabella Bisceglia²Maurizio Zizzo¹Andrea Morini¹Fortunato Morabito³Magda Zanelli¹Antonino Neri¹Carmine Pinto¹Lucia Mangone^2*

• ¹Azienda Unita Sanitaria Locale - IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia, Reggio Emilia, Italy
• ²EPIDEMIOLOGY UNIT, AUSL-IRCCS REGGIO EMILIA, Reggio Emilia, Italy
• ³Gruppo Amici Dell'Ematologia Foundation-GrADE, Reggio Emilia, Italy

Background: This study aims to evaluate postoperative complications and length of stay in colorectal cancer patients undergoing ERAS versus non-ERAS procedures in a population-based cohort in northern Italy. Methods: Patient characteristics (ASA, tumourtumor site, stage, treatment, BMI) were used. Complications, stratified by Clavien-Dindo and length of stay (LOS), were reported. The odds ratio (OR) and 95% confidence interval (CI) were calculated to evaluate the difference between ERAS and non-ERAS patients. Results: A total of 319 patients were included, divided into the non-ERAS group (113 patients) and the ERAS group (206 patients). Non-ERAS vs ERAS group showed more complications (16.8% vs 13.6%; p-value 0.44) and more days of hospitalization (7.3 vs 4.8; p-value <0.01), but less re-surgery (3.5% vs 4.4%; p-value 0.72), new hospitalizationsentry (3.5% vs 5.8%; p-value 0.37) and death at 30 days (0.9% vs 1.5%; p-value 0.66). Multivariate analysis revealed an increased risk in patients with ASA 4 [OR 6.6; 95% CI 1.9-22.6] and a modest, non-significant increase risk in the non-ERAS group, although the latter was not statistically significant [OR 1.3; 95% CI 0.7-2.5]. Conclusions: ERAS procedures appear to be able to allow intervention even in older patients and those with comorbidities, without compromising the results.