P821 Improving outcome after Inflammatory Bowel Disease surgery in an Enhanced Recovery After Surgery setting
Juvik, A.F.(1)*;Poulsen, J.K.(1);Roikjaer, O.(1);Fransgaard, T.(1);
(1)Zealand University Hospital, Department of Surgery, Koege, Denmark;
Enhanced Recovery After Surgery (ERAS) has been known to improve patient outcome after colorectal cancer surgery. However, far less data exists on ERAS used in patients undergoing surgery for Inflammatory Bowel Disease (IBD).
From March 2020 our surgical IBD patients were admitted to a dedicated colorectal ward instead of a general surgery ward. The colorectal unit already had a history of ERAS for colorectal cancer patient and has specialized ERAS-nurses. The goal was also that IBD-surgery preferably was done by two surgeons from the colorectal team.
Data on all elective IBD surgery in our department from January 2018 through June 2022 was collected from our local IBD-surgery database in order to compare Length of Stay (LOS), readmission rates, surgical approach and complication rates before and after March 2020.
In total 233 patients underwent resections on small bowel, colon or rectum in our institution in a 4.5 year period. Patients undergoing emergency surgery were excluded. In the first period until March 2020, 105 patients were operated and in the second period until June 2022, 128 patients went to surgery. The demographic data (Table 1) show two comparable groups as it does for type of surgery (Table 2).
The median LOS decreased from 6 to 4 days over time and the readmission rate was not significantly changed in the same period. Laparoscopic surgery was done on a larger percentage of the patients in the later period and the conversion-rate was significantly decreased in the same period. There was no difference in surgical complication rate (Table 3).
Admitting IBD patients undergoing surgery to a dedicated unit with specialized surgeons and nurses in an ERAS setting can reduce LOS and improve the surgical technique.