The 'Lazio Network' experience. The first Italian regional research group on the Enhanced Recovery After Surgery (ERAS) program. A collective database with 1200 patients in 2016-2017

AIM: Enhanced Recovery After Surgery (ERAS) guidelines represent one of the most important steps forward in colorectal surgery in the last ten years. Despite the well-known and demonstrated positive impact on the clinical outcomes that this pathway provides, a cultural revolution in patient management is needed. This is not easy to obtain, especially in small and peripheral centers. In Italy, the diffusion of minimally invasive surgery and "fast-track" perioperative management of the patient is rapidly spreading, even in the central and southern regions. However, in these regions, the percentage of laparoscopic colorectal procedures is dramatically less than in the north of Italy. In this context, the idea of a research group based in Rome focused on the development and spreading of ERAS protocols in the Lazio Region was developed.METHODS: A research group, based in Rome, was founded in December 2016 to evaluate the diffusion of the ERAS program over the main colorectal centers of the region. This "Lazio Network" began with a group of surgeons and anesthesiologists from 5 hospitals. After one and half years, the project now includes 17 hospitals in the region. A multicenter database was created, including consecutive patients who underwent laparoscopic colorectal resection following the ERAS program in the participating centers between January 2016 and December 2017.RESULTS: Data for more than 1200 patients were collected over the observed period. The rate of minimally invasive surgery was higher compared to the regional rate (90% vs. 30%), adherence to the ERAS pathway was around 60% of the items per patient. A clinical study will result from this database. The objective is to evaluate the mean number of ERAS items applied, the most common and uncommon items applied and the influence of this application on the clinical outcomes.CONCLUSIONS: The adoption of the ERAS program is rapidly increasing even in central Italian regions, even though the total rate of minimall