Assessment of the Effectiveness of Enhanced Recovery after Surgery (ERAS) Programs for Gastrectomy Iraqi Patients

BACKGROUND: Over the past decades, the ERAS program has shown great benefit and efficacy in managing gastrectomy for patients with gastric cancer.

AIM: This study aimed to ascertain and enrol the benefits of the ERAS programme in terms of clinical outcomes for patients undergoing gastrectomy for gastric cancer.

PATIENTS AND METHODS: In different hospitals in Iraq, clinical and demographic data were collected for patients with gastric cancer who underwent Laparoscopic distal gastrectomy (LDG). This included 96 patients between March 2023 and October 2024. The clinical outcomes of patients were recorded before and after gastric cancer surgery. The effectiveness of the Enhanced Recovery After Surgery (ERAS) program was evaluated, as well as their impact on patients.

RESULTS: The current findings indicate that the gastric antrum was the most prevalent location of the tumour in patients undergoing laparoscopic distal gastrectomy (LDG) for gastric cancer. This was observed in 48.96% of the total number of patients. The operative time for laparoscopic distal gastrectomy (LDG) ranged from 2 to 4 cases, with an intraoperative bleeding volume of 140. The mean volume was 57 ± 13.63 mL, and the proportion of cases undergoing lymphadenectomy (%) D2 was 54. The mean length of stay was 5.2 ± 0.3 days, and four cases were transferred to the ICU. The 60-day mortality rate was only one case. The proportion of complications classified as mild was 28 cases, moderate was 16 cases, and severe was seven cases. In terms of the success of the ERAS Compliance Score on gastrectomy patients, we demonstrated that multimodal pain management had an average score of 87.44 ± 5.80, postoperative complications had an average score of 75.02 ± 5.88, postoperative nutrition had an average score of 88.74 ± 3.92, and patient satisfaction had an average score of 81.66 ± 5.78.

CONCLUSION: Even though there were no changes in morbidity and mortality rates, ERAS for gastrectomy enhanced the recovery of patients' mortality rate and minimized hospitalization costs.