578. ENHANCED RECOVERY AFTER SURGERY (ERAS) IN PATIENTS UNDERGOING OESOPHAGECTOMY: A PROSPECTIVE OBSERVATIONAL STUDY

Esophagectomy remains the main stay of treatment in localized esophageal carcinoma. Radical Esophagectomy is associated with high morbidity and mortality. To minimise peri and post-operative complications and accelerate recovery, concept of ERAS has been introduced. Standardized ERAS guidelines were lacking in esophagectomy patients until the ERAS society published their guidelines in late 2018. This is a prospective observational study were ERAS protocol was followed for all patients undergoing esophagectomy during the study period (July 2020 to November 2021). Aim of the study was to compare the post-operative morbidity and mortality associated with ERAS protocol to published historical data from same institute. All patients undergoing esophagectomy for carcinoma of esophagus and GEJ were included and all the components of ERAS protocol as specified in the published guidelines were followed during the study. Out of 52 patients, 36 underwent minimal invasive procedure and 15 had open surgery. Median age was 59.5 years. Average blood loss for thoracic part was 150 ml and 100ml for the abdominal. 37/52 (71.15%) were extubated and rest were electively ventilated till next morning. Median post-operative ICU stay was one day (1-2) and over all hospital stay was 10 days (9-12). Overall morbidity was 11/52 (21.15%) with major morbidity in 4/52 (7.69%); there was no mortality. 2/52 (3.84%) had anastomotic leak. It was possible to follow the ERAS protocol for patients undergoing esophagectomy. The incidence of post-operative morbidity and mortality was no different from that seen in patients undergoing similar surgery before the implementation of ERAS protocol. The probable reason is many of the components of ERAS protocol were followed in our practice routinely. Notwithstanding our results, ERAS program is a collective responsibility and should be recommended in all patients undergoing esophagectomy to improve post-operative outcomes.