Efficacy and Feasibility of Enhanced Recovery after Open Renal Surgery in Cairo University Hospital

Advances in medical technology has allowed for the existence of minimally invasive surgical techniques which has been useful for different surgeries especially renal surgeries. However, a more traditional open approach is many times needed due to the patient’s condition or the nature of the disease or its recurrence. These surgeries entail many factors that may limit early discharge, for example, pain from the lumbar incision, atelectasis, ileus, and nausea, which results in longer length of hospital stay. Enhanced recovery after surgery (ERAS) is a multidisciplinary concept that can improve recovery, optimize physiological condition, and reduce surgical stress and complications; yet there is lack of research concerning ERAS after open renal surgery. ERAS includes different perioperative strategies that are mostly investigated on an individual basis as avoiding prolonged fasting, reducing opioid usage, early initiation of oral diet, and early mobilization. Our aim was to implement these different methods into a single multimodal perioperative care protocol with the hypothesis that this combination will be of greater benefit than conventional perioperative management for the patients, regarding the reduction of length of hospital stay, incidence of complications and readmission rate in patients undergoing open renal surgery.