Shifting the paradigm of peri-oprative care in colorectal surgery in a Sri Lankan tertiary care unit

Enhanced recovery after colorectal surgery (ERAS) protocol is a multimodal perioperative care pathway aiming to reduce stress response to surgery. It helps to return to normal physiology at earliest with minimum complications compared to traditional care pathway in colorectal surgery. In order to have intended benefits of ERAS, accurate staging of the patients with colorectal cancer is invaluable. Pretreatment pelvic MRI scan is the gold standard in rectal cancer staging due to its proven benefits.

 

While preoperative MRI scan in rectal cancer patients with internationally recognized reporting protocol has been encouraged, ERAS with some modifications (mERAS) has been introduced at the university surgical unit of the Colombo south teaching hospital to overcome the resource limitations at local setting.

 

Modified ERAS protocol was well tolerated by our cohort of patients and the favourable outcomes of ERAS protocol in our centre are comparable with published data. Therefore mERAS would be a safe alternative to the traditional practice of colorectal surgery in Sri Lanka.

 

This article describes the methods of mERAS implementation and the strategies adhered in shifting the paradigm of perioperative care in colorectal surgery at our centre.