Background and Goal of Study: The use of ERAS pathways has proven to reduce care time after colorectal surgery. The aim of this study is to evaluate the effectiveness of an ERAS program based on hospital length of stay (LOS), readmission rates and postoperative Clavien-Dindo complications.
Materials and Methods:a total of 256 patients were included. We compared the first 121 consecutive patients that participated in the ERAS group (from May 2016 to January 2017) with 135 consecutive patiens that were operated prior to the implementation of the ERAS (from January to December 2015). The
 inclusion criteria were: elective colorectal surgery, over 18 years old, appropiate cognitive state and ASA I-II-III. The exclusion criteria were: urgent surgery and existence of higher concomitant surgical processes. All variable data were descriptively analyzed via SPSS version 20.0. The results are presented as number
of patients (%) or mean±standard deviation. Chi-square and Fisher exact test were applied for the study of categorical varibles and the Student t test was used for normally distributed quantitative variables. Results were considered statistically significant when p value<0.05.
Results and Discussion: The two groups were homogeneus. No statistically significant differences were found in terms of age, sex, ASA, diagnosis, TNM stage in colorectal cancer, preoperative hemoglobin, length of surgery... The average compliance with the ERAS protocol was 74.3%. ERAS decreased LOS (9.8±3.7 vs 11±3.8, p 0.018), but not the 30-days readmission rates (12 (9.9%) vs 15 (11.1%), p 0.756) or the number of postoperative complications according to Clavien-Dindo classification (38 (31.4%) vs 49 (36.3%), p 0.49) or the rate of reinterventions (9 (7.4%) vs 11 (8.1%), p 0.833). ERAS improved secondary variables in a statistically significant way: more laparoscopic surgery (45 (37.2%) vs 27 (20%), p 0.006); greater use of regional analgesia in the intraoperative period; more rapid adherence to ambulation, a faster onset of oral liquid diet and analgesia by mouth and lower requeriments of opioids in the postoperative period.
Conclusion(s): ERAS program shortened LOS without increasing 30-days readmission rates. We need to increase patients′ compliance to the protocol to improve our results in future studies.

01 / Enhanced Recovery After Surgery Protocol(ERAS) for elective colorectal surgery in the University Hospital of Guadalajara, Spain: a prospective cohort study.