Enhanced Recovery after Digestive Surgery at the Dalal Jamm National Hospital Center: A Randomized Prospective Study in Adults

Objective: To evaluate the practice of RAAC at the Dalal Jamm National Hospital Center (CHNDJ). Patients and Methods: Prospective randomized single-center study over a 12-month period (January-December 2023) in the intensive care and general surgery departments of Dalal Jamm Hospital. Data analysis was performed using Excel and SPSS software. Results: During the study period, 107 patients were included, divided into two groups: an RAAC group (n=64) and a control group (n=43). The average age was 46.03 years, with a predominance of females and a sex ratio of 0.79. Hepatobiliary surgery was the most common type of surgery performed (45%), followed by colorectal surgery (23%) and pancreatic surgery (13%). Gallstones were the main indication (33%), followed by colorectal tumors (21%) and duodenopancreatic tumors (13%). For the RAAC group, postoperative pain was controlled at H2 vs. H12 for the control group. The average time to ambulation was at H3 vs. H5 for the control group, and feeding was resumed at H8 vs. D1 for the control group. In our series, four cases of postoperative ileus were noted in the control group. The outcome was favorable in 98% of the RAAC group vs. 86% of the control group. Anastomotic leakage was the main surgical complication (n=3). Mortality was 7% in the control group and zero in the RAAC group. The average length of stay was 6 days (2-21 days) for the RAAC group vs. 8 days (2-13 days) for the control group. Conclusion: The implementation of ERAS has reduced postoperative morbidity and mortality, shortened the average length of stay, and improved recovery in patients undergoing digestive surgery.