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 Ann. Ital. Chir., 90, 2, 2019 157 Ann. Ital. Chir., 2019 90, 2: 157-161 pii: S0003469X19029622 Pervenuto in Redazione Ottobre 2018. Accettato per la pubblicazione Novemmbre 2018 Correspondence to: Michele Grieco, General Surgery Department, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy (e-mail: dr.griecomichele@gmail.com) Michele Grieco*, Graziano Pernazza**, Marcello Gasparrini***, Paola Marino°, Fabrizio Apponi°°, Roberto Persiani°°° Antonio Brescia***, on Behalf of the "Lazio Network" *General Surgery Department, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy **Minimally Invasive and Robotic Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy ***Department of General Surgery, “Sant’Andrea” University Hospital, “Sapienza” University of Rome, Rome, Italy °Department of Anesthesiology, “San Giovanni-Addolorata” Hospital, Rome, Italy °°Department of Anesthesiology, “Sant’Andrea” University Hospital, “Sapienza” University of Rome, Rome, Italy °°°General Surgery Department, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy 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 colorec- tal 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. Tis is not easy to obtain, especially in small and peripheral centers. In Italy, the difusion of minimally invasive surgery and “fast-track” perioperative man- agement 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 difusion of the ERAS program over the main colorectal centers of the region. Tis “Lazio Network” began with a group of surgeons and anes- thesiologists from 5 hospitals. After one and half years, the project now includes 17 hospitals in the region. A multi- center 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. Te 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. Te objective is to evaluate the mean number of ERAS items applied, the most common and uncommon items applied and the infuence of this application on the clinical outcomes. CONCLUSIONS: Te adoption of the ERAS program is rapidly increasing even in central Italian regions, even though the total rate of minimally invasive surgery procedures still low. Benefts in terms of clinical outcomes will be evaluated from the analysis of a multi-center database of patients treated between January 2016 and December 2017, including more than 1200 patients. KEY WORDS: Coloretal surgery, ERAS guidelines, Fast track surgery Introduction Te ERAS pathways of perioperative management form an evidence-based model that can decrease surgical stress and improve postoperative recovery. It is a multimodal READ-ONLY COPY PRINTING PROHIBITED