AI Article Synopsis
- The article reviews enhanced recovery after surgery (ERAS) programs specifically for a type of surgery called esophagectomy.
- ERAS helps patients recover faster and have fewer problems after surgery, but there hasn’t been much research on it for esophagectomy.
- The authors found some positive results from past studies, but overall evidence is weak, and they suggest more guidelines and research are needed for better practices.
Article Abstract
Objective: This article aims to provide the first systematic review of enhanced recovery after surgery (ERAS) programs for esophagectomy and generate guidelines.
Background: ERAS programs use multimodal approaches to reduce complications and accelerate recovery. Although ERAS is well established in colorectal surgery, experience after esophagectomy has been minimal. However, esophagectomy remains an extremely high-risk operation, commonly performed in patients with significant comorbidities. Consequently, ERAS may have a significant role to play in improving outcomes. No guidelines or reviews have been published in esophagectomy.
Methods: We undertook a systematic review of the PubMed, EMBASE, and the Cochrane databases in July 2012. The literature was searched for descriptions of ERAS in esophagectomy. Components of successful ERAS programs were determined, and when not directly available for esophagectomy, extrapolation from related evidence was made. Graded recommendations for each component were then generated.
Results: Six retrospective studies have assessed ERAS for esophagectomy, demonstrating favorable morbidity, mortality, and length of stay. Methodological quality is, however, low. Overall, there is little direct evidence for components of ERAS, with much derived from nonesophageal thoracoabdominal surgery.
Conclusions: ERAS in principle seems logical and safe for esophagectomy. However, the underlying evidence is poor and lacking. Despite this, a number of recommendations for practice and research can be made.
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| http://dx.doi.org/10.1097/SLA.0000000000000349 | DOI Listing |
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