Goals: Enhaced recovery after surgery programs (ERAS) have managed to reduce the surgical agression response, lowering morbidity, mortality and lenght of hospitalary stay. Postoperative paralytic ileus (PPI) is one of the complications associated which delays recovery and may prolong the stay. PPI is multifactorial and has several etiopathogenic mechanisms; ERAS protocol establishes a series of measures to reduce its frequency. Our goal is to check if there is lower PPI frequency after ERAS protocol measures application, compared to the standard cares, prior to its establishment. Our second goal is to analize if the decrease in the ileus frequency, as well as other complications, may shorten hospital stay. Materials and Methods: We compared a retrospective Pre-ERAS group and a prospective ERAS group: · ERAS: 165 patients between january and november 2017 under ERAS protocol, which consists of:    - Carbohydrate drinks the night before  and 2h before surgery    - Preoperative use of analgesic coadjuvants    - Preferred laparoscopic approach    - IV lidocaine and magnesium sulphate.    - Restrictive fluid therapy regime 3-5ml/kg/h
    - Limited use of drains and nasogastric tube.    - Multimodal analgesia: Thoracic epidural, regional blockades and NSAIDs . Restricted opiate use.    - Early oral tolerance.    - Early mobilization. · Pre-ERAS: 65 patients between july and october 2015, under standard measurements. Results: ERAS group’s mean age was 67,54 ±12.34 vs 65.8 ± 13.88 in Pre-ERAS group. Male sex 61% in ERAS group vs 62%. Laparoscopic approach 65% vs 58%, mean surgery duration 195,6 minutes ± 76.12 vs 179 mins ± 82 and postoperative opiates use 17% vs 43%. We found lower ileus frequency 16.88% vs 29.23%, mean hospitalary lenght of stay of 8.98 days ± 7.04 vs 11.9 ± 10.9, mean lenght of stay reduction of 2.9 days in ERAS group compared to Pre-ERAS group. Our goal was to discharge patient on the 5th postoperatory day and we found in ERAS cohort 27.8% of the patients could be discharged on 5th postoperatory day vs 9.1%. Conclusions: ERAS protocol application seems to reduce PPI frequency and may allow an early hospital discharge and a reduction in health spending. 

06 / Do we decrease the frequency of paralytic ileus after colorectal surgery using an ERAS protocol?