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Review
. 2022 Sep;24(9):1177-1187.
doi: 10.1007/s11912-022-01282-4. Epub 2022 Apr 11.

Enhanced Recovery After Surgery (ERAS) in Surgical Oncology

Javier Ripollés-Melchor  1   2   3 , Ane Abad-Motos  4   5 , Andrés Zorrilla-Vaca  6   7
Affiliations
Review

Enhanced Recovery After Surgery (ERAS) in Surgical Oncology

Javier Ripollés-Melchor et al. Curr Oncol Rep. 2022 Sep.

Abstract

Purpose of the review: The objective of this review is to address the rationale behind the application of the Enhanced Recovery After Surgery (ERAS) protocols that could improve oncologic outcomes in adult patients undergoing major surgery.

Recent findings: The implementation of ERAS protocols has been associated with fewer postoperative complications as well as decreased return to intended oncologic treatment (RIOT). However, few studies have analyzed the influence of the application of ERAS protocols and long-term oncologic outcomes, although some of its individual elements have been associated with improvements in oncologic outcomes, including overall survival and disease-free survival. Targeted long-term follow-up studies in specific oncologic procedures are required to determine whether ERAS application results in improved oncologic outcomes.

Keywords: Adenocarcinoma/surgery; Analgesia*/mortality; Anesthesia, conduction/adverse effects; Colonic neoplasms/pathology; Colonic neoplasms/surgery; Disease progression; Disease-free survival; Humans; Laparoscopy; Neoplasm recurrence, local/mortality; Neoplasm recurrence, local/prevention and control; Neoplasm staging; Neoplasms/immunology; Neoplasms/mortality; Survival analysis; Treatment outcome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Kehlet H. Enhanced Recovery After Surgery (ERAS): good for now, but what about the future? Can J Anaesth. 2015;62:99–104. - PubMed - DOI
    1. Kehlet H, Mogensen T. Hospital stay of 2 days after open sigmoidectomy with a multimodal rehabilitation programme. Br J Surg. 1999;86:227–30. - PubMed - DOI
    1. Ljungqvist O, Scott M, Fearon KC. Enhanced recovery after surgery: a review. JAMA Surg. 2017;152:292–8. - PubMed - DOI
    1. Singh SM, Liverpool A, Romeiser JL, Thacker J, Gan TJ, Bennett-Guerrero E. Types of surgical patients enrolled in enhanced recovery after surgery (ERAS) programs in the USA. Perioper Med (London, England). 2021;10:12. - DOI
    1. •• Lee Y, Yu J, Doumouras AG, Li J, Hong D. Enhanced recovery after surgery (ERAS) versus standard recovery for elective gastric cancer surgery: a meta-analysis of randomized controlled trials. Surg Oncol. 2020;32:75–87. This meta-analysis, which included 14 studies, showed that the application of ERAS in gastric cancer can reduce length of stay, costs and time to return to function after gastric cancer surgery compared to conventional recovery. However, ERAS may increase the number of postoperative readmissions, although with no impact on the rate of postoperative complications, and there was no analysis of oncologic outcomes. - PubMed - DOI

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