ORIGINAL RESEARCH article
Front. Surg.
Sec. Colorectal and Proctological Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1710191
This article is part of the Research TopicEvaluating surgical techniques and perioperative strategies in colorectal cancer treatmentView all 7 articles
ERAS protocol versus conventional care in elective laparoscopic colorectal cancer surgery in Hatyai Hospital
Provisionally accepted- 1Hatyai Hospital, Hat Yai, Thailand
- 2Office of Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand
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Background: Enhanced Recovery After Surgery (ERAS) programs and laparoscopic techniques independently reduce hospital stays and postoperative complications in colorectal cancer patients. However, evidence regarding whether the combination of ERAS protocols with laparoscopic surgery further improves postoperative outcomes remains limited. Objective: To compare the postoperative hospital stay(POHS) and peri-operative outcomes between patients undergoing elective laparoscopic colorectal cancer surgery under the ERAS protocol and conventional care. Methods: This ambispective cohort study included patients who underwent elective laparoscopic colorectal surgery for colorectal adenocarcinoma at Hatyai Hospital between June 2019 and May 2023. Patients were divided into conventional group and ERAS group. The primary outcome was POHS. Secondary outcomes included postoperative complications and 30-day readmission. Results: A total of 140 patients were included (70 ERAS, 70 conventional). Baseline characteristics were similar between groups, though ERAS group had more preoperative CCRT (52.9% vs. 39.4%, p = 0.002) and diverting stomas (38.6% vs. 21.4%, p = 0.042). The ERAS group had significantly shorter POHS (median 5.0 vs. 5.5 days, p < 0.001), earlier oral intake (3 vs. 4 days, p = 0.001), and earlier JP drain removal (p = 0.006). No significant differences in postoperative complications, readmission, or mortality. Multivariate analysis identified early JP drain removal, early discontinuation of intravenous fluids, NG tube avoidance and multimodal analgesia as significant predictors of POHS ≤ 5 days. Conclusion: ERAS implementation in elective laparoscopic colorectal cancer surgery significantly reduces hospital stay without increasing complication or readmission rates. These findings support the safety and effectiveness of ERAS in a regional Thai hospital setting and advocate for broader protocol adoption .
Keywords: Eras, Laparoscopic colorectal surgery, colorectal cancer, Enhanced recovery after surgery, Hospital stay
Received: 21 Sep 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Prasitvarakul, Paekaittiwong, Tumviriyakul and Khaimook. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Kamales Prasitvarakul, kamalesmd9@gmail.com
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