Enhanced Recovery Programme in Abdominal Surgery ; Pažangi Pooperacinė Reabilitacija
Enhanced recovery program in abdominal surgery, also known as ERAS, is a protocol used before, during, and after operations, with the goal of improving the well-being of the patient, by facilitating the recovery and making everything possible to decrease the postoperative complications. This system requires a specialized team, consisting mainly on anaesthesiologists, nurses, and surgeons, however, physiotherapists, nutritionist or administrative department can also be involved, according to the individual needs. ERAS programme is not yet introduced worlwide, not even in most of hospitals, due to a number of difficulties which makes it arduous. According to studies, such problems include accomplishing the compliance and keep it for long term, resistance to implementation, lack of communication or collaboration among the medical professionals, lack of financial resources, and patient education, being the compliance and resistance the most prevalent ones. Embracement of such a multimodal protocol with so many professionals involved is quite difficult, since a traditional surgical dogma has been in hospitals for years, and it takes a long time to change their beliefs. Therefore, first thing to accomplish the implementation is the education, not only for the medical staff, but also for the patients undergoing major surgeries, because a clear understanding of the protocol is the main goal for achievement. This education should be continued for a long term, in order to keep the compliance in high rates, so seminars, informative brochures or any other form of educational material could be taken into account. Another way to success is to make some changes in the postoperative ward, which according to studies they show the lowest compliance rate, so if they are more friendly towards the patient and they are transformed into a rehabilitation center, well-being of the patient could be achieved better than with actual wards. Hence, ERAS programme is a revolutionary protocol for most of the hospitals, which is trying to be introduced, since the goal is facilitating the recovery and well-being of patients undergoing major surgeries. It confronts some difficulties, however solutions can be carried out to achieve the implementation.