Enhanced Recovery Versus Standard Care After Emergency Abdominal Surgery in Patients Requiring Emergency Laparotomy

Comparison of Enhanced Recovery Protocol After Surgery Versus Conventional Care in Emergency Laparotomy

This study aims to compare an Enhanced Recovery After Surgery (ERAS) protocol with conventional postoperative care in adults undergoing emergency laparotomy for intestinal obstruction or intestinal perforation.

The main question this study aims to answer is:

• Does the ERAS protocol reduce surgical site infections compared with conventional care after emergency laparotomy?

Researchers will also compare other recovery outcomes between the two groups, including length of hospital stay, occurrence of paralytic ileus (temporary loss of bowel function), time to first bowel movement, and time to start taking fluids by mouth after surgery.

A total of 102 participants will be enrolled and randomly assigned to one of two groups. One group will receive postoperative care according to the ERAS protocol, while the other group will receive conventional postoperative care. All participants will undergo emergency laparotomy using standard surgical and anesthetic techniques.

Participants will:

• Undergo emergency laparotomy for intestinal obstruction or intestinal perforation.
• Receive either ERAS-based postoperative care or conventional postoperative care.
• Be monitored during their hospital stay for recovery and postoperative complications.
• Be assessed for bowel function recovery, ability to tolerate oral fluids, and length of hospital stay.
• Be followed for 30 days after surgery to determine whether a surgical site infection develops.

The researchers hypothesize that patients managed with the ERAS protocol will have a lower frequency of surgical site infections and improved postoperative recovery compared with those receiving conventional care.

Inclusion Criteria:

• acute intestinal obstruction or intestinal perforation
• planned for emergency laparotomy

Exclusion Criteria:

• Pregnant women
• Patients on chronic steroids
• Chronic obstructive pulmonary disease
• Malignant ulcers confirmed by histopathological examination
• laparoscopic surgeries
• Acute abdominal trauma
• Patients who require postoperative intensive care unit (ICU) care