Trends in enhanced recovery after surgery (ERAS) in thoracic surgery from a bibliometric insight

Abstract

Background: In thoracic surgery, the concept of Enhanced Recovery After Surgery (ERAS) has been extensively implemented. Although numerous studies have investigated ERAS in thoracic surgery, bibliometric analyses remain limited. In this study, the developmental trajectory, current research status, and prospective trends of ERAS in thoracic surgery were systematically analyzed through bibliometric and visual analysis techniques.

Methods: Literature pertaining to ERAS in thoracic surgery was retrieved from the Web of Science Core Collection (WoSCC). Microsoft Excel 2019, R software (version 4.1.0), the Bibliometric Online Analysis Platform, VOSviewer (version 1.6.18), and Citespace (version 6.3.R1) were utilized for statistical analysis, bibliometric evaluation, and data visualization.

Results: A total of 617 publications were retrieved over the past decade. The number of publications has generally demonstrated an upward trend from 2015 to 2024. China and Sichuan University ranked as the leading country and institution, respectively, in terms of publication volume. The Journal of Thoracic Disease was identified as the leading journal in both publication count and citation frequency. Henrik Kehlet was recognized as the most prolific and highly co-cited author. Current research hotspots include "video-assisted thoracic surgery," "pain management," and "multicenter clinical trials."

Conclusion: ERAS-related research in thoracic surgery has been increasing steadily, highlighting it as a rapidly evolving and promising field. The ERAS concept plays a critical role in all perioperative phases-preoperative, intraoperative, and postoperative-and requires further in-depth investigation. Many existing ERAS studies in thoracic surgery lack high-quality evidence, underscoring the urgent need for rigorously designed research with robust methodological standards.

Keywords: Bibliometric analysis; Citespace; ERAS; Enhanced recovery after surgery; Thoracic surgery; VOSviewer.

Fig. 1

Retrieval strategy and data filtering procedure

Fig. 2

The annual volume and trend of publications on the ERAS in thoracic surgery

Fig. 3

Geographical distribution of the countries/regions in amount of publications

Fig. 4

International collaboration among countries/regions. The co-authorship network diagram of (A) the countries/regions and (B) institutions. The size of the nodes represents the number of publications, the lines represent cooperation, and the color of the nodes represents the time

Fig. 5

Overlays of co-authorship analysis and average publication time by countries/regions (A) and institutions (B). The lines represent cooperation, and the color of the nodes represents time

Fig. 6

A dual-map overlap of journals of ERAS in thoracic surgery. The left is the cited journal and the right is the cited journal, the lines between cited journal and cited journal represent the citation relationship

Fig. 7

The co-authorship network map for the author

Fig. 8

The co-citation network map of co-cited authors. The lines represent citations

Fig. 9

The co-cited network map of references. The purple rings on the outside of the nodes represent centrality

Fig. 10

The cluster and co-occurrence map of keywords

Fig. 11

The burst detection map of keywords from the decade of ERAS in thoracic surgery