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Review
. 2020 Apr;50(4):323-334.
doi: 10.1007/s00595-020-01956-1. Epub 2020 Feb 11.

The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection

Apurva Ashok  1 , Devayani Niyogi  1 , Priya Ranganathan  2 , Sandeep Tandon  3 , Maheema Bhaskar  3 , George Karimundackal  1 , Sabita Jiwnani  1 , Madhavi Shetmahajan  2 , C S Pramesh  4
Affiliations
Review

The enhanced recovery after surgery (ERAS) protocol to promote recovery following esophageal cancer resection

Apurva Ashok et al. Surg Today. 2020 Apr.

Erratum in

Abstract

Esophageal cancer surgery, comprising esophagectomy with radical lymphadenectomy, is a complex procedure associated with considerable morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol which aims to improve perioperative care, minimize complications, and accelerate recovery is showing promise for achieving better perioperative outcomes. ERAS is a multimodal approach that has been reported to shorten the length of hospital stay, reduce surgical stress response, decrease morbidity, and expedite recovery. While ERAS components straddle preoperative, intraoperative, and postoperative periods, they need to be seen in continuum and not as isolated elements. In this review, we elaborate on the components of an ERAS protocol after esophagectomy including preoperative nutrition, prehabilitation, counselling, smoking and alcohol cessation, cardiopulmonary evaluation, surgical technique, anaesthetic management, intra- and postoperative fluid management and pain relief, mobilization and physiotherapy, enteral and oral feeding, removal of drains, and several other components. We also share our own institutional protocol for ERAS following esophageal resections.

Keywords: Enhanced recovery; Esophageal surgery; Esophagectomy.

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Conflict of interest statement

Dr Apurva Ashok and the co-authors of this paper have no conflicts of interest to declare

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