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

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.