GMKA Study on ERAS Adoption for Colorectal Procedures in Ukraine Published in the World Journal of Surgery
The Global Medical Knowledge Alliance (GMKA) research team has conducted the first nationwide survey of Ukrainian surgeons, anesthesiologists, and hospital administrators to assess the implementation of Enhanced Recovery After Surgery (ERAS) protocols for colorectal procedures. The findings of this study were published as a research letter in the World Journal of Surgery.
Colorectal cancer remains a major public health challenge in Ukraine, accounting for 13.5% of all cancer cases. Surgery is required for most patients, but postoperative complications are common, leading to increased morbidity, mortality, prolonged hospital stays, and a higher burden on the healthcare system.
ERAS protocols have been proven to reduce complications and optimize medical resource use. However, their adoption in Ukraine remains inconsistent, partly due to limited access to up-to-date treatment guidelines and educational materials.
Key Findings from the Study
The GMKA team surveyed 282 healthcare professionals: 110 surgeons (39.0%), 134 anesthesiologists (47.5%), 38 hospital administrators (13.5%).
Using a questionnaire based on ERAS Society Guidelines, the study revealed:
- Full ERAS implementation is rare—only 12.4% of respondents reported full adoption of ERAS protocols.
- Private hospitals lead in ERAS adoption, with 40.7% reporting full implementation, compared to 8.7% in urban hospitals and 6.7% in rural hospitals.
- Partial adoption is common, with 87.6% of respondents using at least some ERAS components.
- Postoperative ERAS measures are most widely implemented, while pre- and intraoperative practices are less frequently adopted.
Addressing Barriers to ERAS Implementation
The higher adoption rate in private hospitals highlights disparities in access to updated protocols and specialized training. Translating ERAS guidelines into a national language and improving access to educational resources could help bridge this gap and encourage broader implementation.
While full ERAS adoption yields the greatest benefits, a phased approach focusing on relatively low-cost, yet high-impact components—such as proper antibiotic use, early patient mobilization, and oral intake—can drive immediate improvements.
For Ukraine and other low- and middle-income countries, prioritizing cost-effective ERAS measures is a practical strategy to enhance colorectal cancer treatment outcomes while easing the strain on healthcare systems. The GMKA study lays a foundation for future initiatives aimed at improving surgical care quality across the country.