Impact of Tailored-Enhanced Recovery After Surgery Versus Conventional Care in Patients of Gastro-Duodenal Perforation: A Pilot Randomized Control Trial

Background: The enhanced recovery after surgery (ERAS) program established improved clinical outcomes in elective surgery; however, its role emergencies is uncertain. This study was designed to assess the feasibility, safety, and efficacy of a tailored-ERAS (t-ERAS) protocol patients undergoing modified Graham’s patch closure for gastro-duodenal perforation. Methods: A single-centre, prospective, parallel-arm, open-label, randomized controlled trial conducted from February 2021 December 2021. Patients with gastroduodenal perforation Graham's were randomly assigned either conventional care or t-ERAS pathway. refractory septic shock, psychiatric neurological disorders, pregnancy, multiple perforations, sealed-off sizes greater than 1.5 cm excluded. primary outcome compare length hospitalization (LOH). Functional parameters morbidity compared secondary outcomes. Results: Twenty-five each included group. In group, LOH significantly shorter (6.3 SD2.15 days versus 9.56 SD4.33 days, p = 0.001). group had early functional (days) time first bowel sound (1.8 SD0.41; 0.002), flatus (2.52 SD0.65; 0.026), stool (3.04 SD0.68; < 0.001), liquid diet (2.24 SD0.60; duration ileus (2.64 SD0.86; 0.038). There no significant difference such as post-operative nausea vomiting, SSI, pulmonary complications between two groups. Conclusion: Tailored ERAS pathways are safe effective reducing promoting emergency