Enhanced recovery after surgery protocol allows ambulatory laparoscopic appendectomy in uncomplicated acute appendicitis: a prospective, randomized trial.

Enhanced recovery after surgery protocol allows ambulatory laparoscopic appendectomy in uncomplicated acute appendicitis: a prospective, randomized trial.

Trejo-Ávila ME et al. Enhanced recovery after surgery protocol allows ambulatory laparoscopic appendectomy in uncomplicated acute appendicitis: a prospective, randomized trial. Surg Endosc. 2019 Feb;33(2):429-436. 

What is already known:

The vast majority of ERAS programmes are focused on purely elective surgery. This study focusses on the common emergency operation, appendicitis.

What this paper adds:

In this small RCT patients were randomised into 2 groups (ERAS vs standard care). With the exception for the pre-admission elements, this was a fairly comprehensive ERAS programme. They demonstrated an impressively short length of stay (a mean of only 9.7 hours to discharge, compared to 23.2 hours in the standard group). There was a reduced time to resume diet and a reduced incidence of moderate to severe pain scores postoperatively (28% vs 62%). There was no difference in complications, reoperations and importantly readmissions.

Chris Jones, Guildford. @chrisnjones