Can an enhanced recovery after surgery (ERAS) programme improve colorectal cancer outcomes in South Africa?

Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most common cause of cancer related deaths. It is estimated that CRC is amongst the top five malignancies in South Africa (SA) with an age standardised incidence rate of 10.2 and 6.1 per 100 000 for males and females respectively. The incidence is projected to increase in South Africa as a result of ageing, a growing population and an increase in prevalence of risk factors

National Priorities for Perioperative Research in South Africa

BACKGROUND:Perioperative research is currently unco-ordinated in South Africa (SA); with no clear research agenda.OBJECTIVE:To determine the top ten national research priorities for perioperative research in SA.METHODS:A Delphi technique was used to establish consensus on the top ten research priorities.RESULTS:The top ten research priorities were as follows: (i) establishment of a national database of (a) critical care outcomes; and (b) critical care resources; (ii) a randomised controlled trial of preoperative B-type natriuretic peptide-guided medical therapy to decrease major adverse cardiac events following non-cardiac surgery; (iii) a national prospective observational study of the outcomes associated with paediatric surgical cases; (iv) a national observational study of maternal and fetal outcomes following operative delivery in SA; (v) a stepped-wedge trial of an enhanced recovery after surgery programme for (a) surgery; (b) obstetrics; (c) emergency surgery; and (d) trauma surgery; (vi) a stepped-wedge trial of a surgical safety checklist on patient outcomes in SA; (vii) a prospective observational study of perioperative outcomes after surgery in district general hospitals in SA; (viii) short-course interventions to improve anaesthetic skills in rural doctors; (ix) studies of the efficacy of simulation training to improve (a) patient outcomes; (b) team dynamics; and (c) leadership; and (x) development and validation of a risk stratification tool for SA surgery based on the South African Surgical Outcomes Study (SASOS) data.CONCLUSIONS:These research priorities provide the structure for an intermediate-term research agenda