CHASE : aCcelerated 23-Hour erAS Care for Colorectal Surgery

Rationale: Throughout the years, there has been a rapid change in the perioperative protocols and procedures surrounding colorectal surgery. Upon the introduction of the Enhanced Recovery After Surgery (ERAS) program in Western countries, an improvement in postoperative outcomes was seen. Nowadays, researchers focus on further improving the current standard ERAS programs enabling an accelerated version hereof.
Objective: The aim of this study is to investigate the feasibility and safety of a 23-hour accelerated ERAS protocol (ERAS 2.0) for patients undergoing colorectal surgery compared to a retrospective cohort of patients who followed ERAS 1.0 for colorectal surgery. In this ERAS 2.0 protocol, patients undergoing colorectal surgery will be discharged within 23 hours after surgery.
Study design: This study is an investigator-initiated, single-center prospective study.
Study population: Patients aged ≥ 18 years ≤ 80 undergoing surgical resection for colorectal pathology that meet the eligibility criteria will be invited to participate in this study.
Intervention: Adhering to a strict multidisciplinary and multifaceted ERAS 2.0 protocol, patients receiving elective colorectal surgery will be discharged 23-hours after surgery.
Main study parameters/endpoints: Rate of the successful and safe application of the 23-hour accelerated ERAS 2.0 protocol for patients undergoing elective colorectal surgery. Success rate will be measured in readmission rate and safety will be measured with rate of serious adverse events (Clavien Dindo ≥3b). Success rate (feasibility) will also be measured in percentage of patients who were not able to be discharged 23 hours after surgery.

研究背景：多年来，结直肠手术的围手术期方案与流程发生了快速变革。随着加速康复外科（Enhanced Recovery After Surgery, ERAS）理念在西方国家推广应用，术后临床转归得到显著改善。当前，研究者致力于进一步优化现有标准ERAS方案，以开发其加速迭代版本。
研究目的：本研究旨在探讨针对结直肠手术患者的23小时加速ERAS方案（ERAS 2.0）的可行性与安全性，并与既往接受标准ERAS（ERAS 1.0）治疗的结直肠手术患者回顾性队列进行对比。该ERAS 2.0方案要求结直肠手术患者于术后23小时内出院。
研究设计：本研究为研究者发起的单中心前瞻性研究。
研究人群：年龄介于18至80岁（含边界值）、符合入组标准且因结直肠病变接受手术切除的患者，将受邀参与本研究。
干预措施：接受择期结直肠手术的患者需严格遵循多学科、多维度的ERAS 2.0方案，并于术后23小时出院。
主要研究指标/终点：针对择期结直肠手术患者，23小时加速ERAS 2.0方案的安全应用成功率。成功率通过再入院率进行评估，安全性则通过严重不良事件发生率（克拉维埃-丁多Clavien-Dindo分级≥3b）进行衡量。此外，可行性相关的成功率还将以术后23小时内未能出院的患者占比进行评估。