A Prospective Comparative Study of Enhanced Recovery After Surgery (ERAS) Versus Conventional Protocols in Emergency Laparoscopic Appendectomies

TL;DR

This study shows that using ERAS protocols in emergency laparoscopic appendectomies leads to faster recovery and less pain compared to traditional methods.

Contribution

Demonstrates the safe and effective adaptation of ERAS protocols for emergency laparoscopic appendectomies.

Findings

ERAS group had significantly shorter hospital stays compared to conventional care.

Patients following ERAS returned to normal activities faster and reported less postoperative pain.

No complications were observed in either group, confirming ERAS safety in emergency settings.

Abstract

Background

Acute appendicitis is among the most common causes of acute abdominal pain requiring surgical intervention. Laparoscopic appendectomy has become the standard of care due to its advantages in terms of reduced postoperative pain, shorter hospital stay, and early return to activity. However, optimizing perioperative recovery in emergency surgical settings remains a challenge. Enhanced Recovery After Surgery (ERAS) protocols, initially developed for elective colorectal surgeries, offer a multimodal approach to improving surgical outcomes and reducing recovery time. Recent studies have shown that ERAS can be safely and effectively adapted for emergency procedures as well.

Objectives

This study was undertaken to evaluate the effectiveness of the ERAS protocol compared to conventional perioperative care in patients undergoing emergency laparoscopic appendectomy by comparing the length of hospital stay, return to routine activities, postoperative pain (Visual Analog Scale {VAS} score), and perioperative complications between the two groups.

Methods

A prospective comparative study was conducted on 62 patients undergoing emergency laparoscopic appendectomy. The patients were divided into two groups: 31 received conventional postoperative care, and 31 followed ERAS protocols. The primary outcomes analyzed were the duration of hospital stay, time to return to normal activity, and postoperative pain (VAS).

Results

The patients in the ERAS group had significantly reduced hospital stay (1.87 ± 0.51 versus 3.16 ± 0.45 days, p < 0.001), earlier return to normal activity (3.43 ± 0.50 versus 3.97 ± 0.80 days, p = 0.003), and lower VAS scores (2.53 ± 0.51 versus 3.29 ± 0.46, p < 0.001). No complications were observed in either group.

Conclusion

The ERAS protocol is a safe and effective perioperative strategy in emergency laparoscopic appendectomy. Its implementation leads to significantly improved postoperative outcomes and can be considered for broader use in acute surgical care.