Implementation of the ERAS in Colorectal Cancer Patients: a Single Arm Study

This multi-center prospective single arm clinical trial aims to investigate each component and item in the ERAS protocol implemented to perioperative care of colorectal cancer patients.

The primary endpoint will be the 'postoperative time to discharge criteria'. Discharge criteria will be defined as meeting all the criteria below:

* No fever * Eating more than half of given solid diet * No nausea or vomiting * Gas passing or defecation * Able to walk (more than 1 hour a day) * No sign of surgical site infection * Adequate pain control with oral analgesics such as acetaminophen and NSAIDs * No sign of any other complication

Secondary outcomes will include:

* adherence of each ERAS item within the protocol * postoperative hospital stay * early postoperative complications (within 30 days of surgery) * postoperative mortality * postoperative pain scores (VAS scores) * re-admission within 30 days of surgery * Quality of Recovery questionnaire * Health-related quality of life questionnaire

The specific ERAS protocol to be used in this study has been developed by Seoul National University Hospital, benchmarking the 2018 ERAS® society guidelines for colorectal surgery. The implementation process has been helped and guided by the ERAS® Implementation Program of the Encare team.

The ERAS protocol includes:

* Pre-admission education, counselling and nutritional support * Pre-induction oral analgesics * Minimal fasting and carbohydrate loading * Omission of nasogastric intubation * Intra-operative abdominal nerve block * Early mobilization * Early oral nutrition and minimal IV fluids * Multimodal opioid sparing analgesia * Postoperative nausea and vomiting prophylaxis * Early removal of urinary catheters

This study aims to establish evidence on the factors affecting adherence and efficacy of each ERAS category, to guide a future pivotal RCT that will aim to develop a personalized, risk-stratified ERAS protocol that considers surgical risk and patient factors.

• Adherence to the ERAS protocol [Срок оценки: From date of enrollment to the date of discharge after surgery, assessed up to 100 days]
• Hospital stay [Срок оценки: From the date of hospital admission until the date of discharge after surgery, assessed up to 100 days]
• Early postoperative complication [Срок оценки: From the day of surgery to the 30th postoperative day]
• Postoperative mortality [Срок оценки: From day of surgery until the end of clinical data gathering, assessed upto 100 days.]
• Postoperative pain score: the Numeric Rating Scale (NRS) [Срок оценки: From day of surgery until the end of clinical data gathering, assessed upto 100 days.]
• Re-admission within 30 days [Срок оценки: From randomization until the end of clinical data gathering, assessed upto 100 days.]
• Health-related Quality of Life [Срок оценки: From randomization until the end of clinical data gathering, assessed upto 100 days.]