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Review
. 2022 Nov;407(7):2619-2627.
doi: 10.1007/s00423-022-02602-9. Epub 2022 Jul 21.

Principles of enhanced recovery in gastrointestinal surgery

Didier Roulin  1 , Nicolas Demartines  2
Affiliations
Review

Principles of enhanced recovery in gastrointestinal surgery

Didier Roulin et al. Langenbecks Arch Surg. 2022 Nov.

Abstract

Background: To reduce the impact of surgery-related stress, enhanced recovery after surgery (ERAS) pathways have been developed since over 15 years with subsequent improved postoperative outcome. This multimodal and evidence-based perioperative approach has spread to all fields of gastrointestinal surgery, from esophagus, stomach, duodenum and pancreas, liver, small intestine and colon, and rectum, as well as for other specialties like vascular and cardia surgeries or neurosurgery, among others.

Purpose: The aim of this state-of-the-art article is to assess current state of evidence on perioperative management specifically in gastrointestinal surgery, with a focus on surgery-related aspects, outcome benefit, and future directions.

Conclusion: The surgical team must promote continuous improvement of the patient's ERAS compliance to ensure optimal perioperative care. Everyday clinical practice should be performed according to latest evidence-based medicine and challenging surgical dogma. Moreover, the surgeon must lead and support a multidisciplinary and collaborative teamwork tailored to patient's need especially with anesthetists and nursing staff.

Keywords: Enhanced recovery; Gastrointestinal surgery.

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Conflict of interest statement

ND is member of the executive committee of the ERAS society.

ND is member of the executive committee of the ERAS society.

Figures

Fig. 1
Fig. 1
Enhanced recovery guidelines for gastrointestinal surgery
Fig. 2
Fig. 2
Summary of common enhanced recovery elements for gastrointestinal surgery. Adm: admission; OP: operative
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