Open AccessEnhanced recovery after surgery (ERAS) programs for esophagectomy
Author(s) -
Mateusz Rubinkiewicz,
Jan Witowski,
Michael Su,
Piotr Major,
Michał Pędziwiatr
Publication year - 2019
Publication title -
journal of thoracic disease
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.682
H-Index - 60
eISSN - 2077-6624
pISSN - 2072-1439
DOI - 10.21037/jtd.2018.11.56
Subject(s) - medicine , esophagectomy , perioperative , protocol (science) , randomized controlled trial , colorectal surgery , surgery , general surgery , surgical stress , esophageal cancer , intensive care medicine , abdominal surgery , alternative medicine , pathology , cancer
A perioperative treatment protocol, enhanced recovery after surgery (ERAS) focuses on accelerating patient recovery. Previous studies confirmed that ERAS decreases surgical trauma and the stress response, which improved outcomes including reduced length of hospital stay (LOS) and decreased postoperative morbidity. While ERAS protocols have been successfully implemented in a variety of surgical disciplines (colorectal, bariatric, orthopedic, and gynecologic surgery), its use in esophageal surgery is still limited. This paper analyzes the feasibility and value of the ERAS protocol for esophageal surgery. Reviewing the literature found that implementation of ERAS resulted in decreased costs, length of stay and pulmonary specific complication reduction, but not overall morbidity. The evidence lacks randomized control trials. Further, the ERAS Society published recommendations for esophageal resection. This opportunity for unification of the protocol would make the studies more comparable and leads to stronger conclusions. Surgery specific items also require further confirmation. Nonetheless, the successful introduction of the ERAS protocol into a wide variety of surgical disciplines provides optimism for ERAS's effectiveness in esophageal surgery.