الفهرس 
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Abstract
Enhanced recovery after surgery (ERAS) program is a new set of protocols that is applied to the patient in the peri-operative period to fasten the recovery and decrease the convalescence and thus improving the surgical outcome. It is also named as Fast track surgery.
In our study we had 40 patients underwent various gastrointestinal surgical operations.The ERAS protocol was implemented on group A with multiple pre, intra and postoperative elements, while group B was managed traditionally .Both groups were closely observed and evaluated during the postoperative period and one month after discharge.
Patients of both groups have undergone the same operations so as to obtain accurate and comparable results .The operations are appendicectomy, cholecystectomy, diverting colostomy, resection anastomosis and repair of perforated peptic ulcer .
Patients of group A have proven less complications than group B. group A showed 6 complicated cases (30%) and group B 10 cases (50%). Detailed complications as in table (7) showed increase incidence of wound infection, chest infection, more incidence of ileus, post operative nausea and vomiting also increase in UTI in group B than groupA, but this difference is insignificant.
In our study there were 5 cases that needed readmission during the first month postoperative , 3 cases in group A (15%) and only 2 cases in group B (10%), but this difference is insignificant. there was an obvious and significant earlier unaided mobilization in group A than group B .
Also there was a clear difference between both groups in length of hospital stay. Patients receiving ERAS protocol stayed definitely shorter period postoperatively.There also was noticed a clear and obvious satisfaction between patients of ERAS group in the form of early mobilization, return to normal activities and pain free.
The results of the present study indicate that ERAS program can significantly accelerate the restoration of gastrointestinal function and reduce the postoperative complications as well as hospital stay time of patients after various gastrointestinal operations.
Recommendations
Enhanced recovery after surgery or ERAS program could be applied safely and effectively in our hospitals. It led to better outcomes, such as a shorter length of hospital stay , early momilization and more patient satisfaction without an increased in 30 days readmission or a higher rate of postoperative complication. A cooperative team including the patient, the surgeon, the anesthetist and the nursing staff is usually required for successful implementation of this program.