Enhanced recovery program after laparoscopic colorectal surgery during the era of COVID-19: a randomized controlled trial

BACKGROUND: COVID-19 pandemic affected health services and made patients delay consultation for medical health problems. Due to the high infectivity of the virus, hospital became full off COVID-19 infected patients, the state of emergency was announced, and the people was forced to stay at home. Moreover, as people were worried to get infected, a decrease in the number of medical consultations was recorded. So, the role of enhanced recovery program is present in decreasing hospital stay, especially for those patients with GI cancer and emergent surgeries. METHODS: The investigators included all patients who were subjected to laparoscopic colorectal surgery at our center between (December 2019 to December 2021) for benign and malignant conditions. Sample size consists of 50 patients, divided into 2 equal groups. Group 1 included 25 patients who were subjected to enhance recovery program after laparoscopic colorectal surgery. Group 2 included 25 patients who were subjected to the traditional way: nothing orally until the disappearance of ileus, then a fluid diet followed by a regular diet after laparoscopic colorectal surgery. RESULTS: Most of the patients tolerated the early oral feeding. The times to first passage of flatus and stool were significantly earlier in group 1. Hospital stay was also significantly less in the early feeding group 1. Operative time and amount of blood loss of early had an effect on the tolerability oral feeding, while age, gender and type of operation had no such effect. The incidence of COVID-19 infection was low in group 1. CONCLUSIONS: Enhanced recovery program after laparoscopic colorectal surgery during the era of COVID-19 decrease postoperative complications and shorten hospital stay and lower healthcare cost and incidence of COVID-19 infection.