Skaraborgs Sjukhus Skövde, Sweden, awarded The Golden Scalpel for their work in ERAS

Lars Johansen, Consultant Surgeon, Eleonora Ingmarsson, Assistant Nurse and Thomas Karlberg, Anaesthetic Nurse.

Congratulations to the ERAS team from Skaraborgs Sjukhus Skövde who were awarded the prestigious Swedish medical price, the Guldskalpellen (The Golden Scalpel), for their introduction and maintenance of their ERAS program. A great achievement in a hard competition with over 30 other nominees. The annual prize is given for the best innovation that has improved the quality of care for patients.

The ERAS® Society becomes a Specialist Society member of the European Society of Anaesthesiology

 At the recent scientific annual meeting of the European Society of Anaesthesiology (ESA) in Vienna, Austria, the Board of Directors of the ESA decided that the ERAS® Society will become a Specialist Society member of the European Society of Anaesthesiology.

With more the 9,700 full members and more than 20,000 associate members, the European Society of Anaesthesiologist is the second largest Anaesthesia Society globally and holds the most prominent position in the community of anaesthesiologist in Europe and elsewhere. The mission of the European Society of Anaesthesiologist is to promote the professional role of anaesthesiologists, to improve perioperative patient outcomes by focusing on the quality of care, patient safety strategy and scientific research.

The objective of this international collaboration is to define joint strategies to promote perioperative care worldwide with the best scientific evidence-based medicine practices according to the ERAS® Society methodology. Furthermore, we have agreed to extend collaboration between the Societies in the field of education and scientific research according to the operational guidelines of the ERAS® Society. The ERAS® Society is asked to submit one or two session proposals for presentation at the scientific annual meeting of the European Society of Anaesthesiology annual ESA congress.

The members of the ERAS® Society will be offered many benefits as part of their membership of the European Society of Anaesthesiology. The Societies will cross announce events of joint interest thereby reaching many more professionals.

We are looking forward to this new international collaboration.
Hans de Boer and Olle Ljungqvist

Report on the 7th ERAS® World Congress

The 7th ERAS® Society World Congress was held at The Arena and Convention Centre Liverpool, UK, from 1 – 3 May 2019. It was held jointly with its UK Chapter, ERAS UK, as their 9th ERAS® UK Conference.

Enjoying the iconic city of Liverpool, the Congress was very successful in attracting 523 registrations  worldwide, with the majority (over 60%) from Europe, but with significant numbers from Asia (20%) and North America (12%) as shown in the table below.

Europe 325
Asia 103
North America 61
Africa 14
Oceania 7
South America 9


There were large numbers of local (UK) delegates and in addition it was encouraging to see that both China and United States supporting the congress in large numbers as well several other European Countries as shown in the table below.

United Kingdom 162
China 52
United States 49
Sweden 30
Netherlands 21
Denmark 17
Switzerland 15
Saudi Arabia 13
Canada 11
Germany 11


Whilst not quite surpassing last year’s record numbers in Stockholm (585) the figures are still much higher than other previous Congresses in Lyon in 2017 (393), Lisbon in 2016 (389) and  Washington  in 2015 (492) – which was a combined meeting with EBPOM and ASER. These figures reflect a sustained interest for ERAS worldwide.

We also had 104 posters presentations (102 last year) with 6 best abstracts selected for oral presentation and 7 rapid fire abstracts accepted. All are published in Clinical Nutrition ESPEN 2019;31:1-146 with a link to the abstracts published here.

The Pre-congress programme (Wednesday 1st May) has now become a packed day with four parallel streams running.  The ever-popular ERAS® half day course where delegates learnt about the relevant pathophysiology and perspectives from different healthcare professionals – surgeon, anaesthetist  and nursing experts. However in addition there were other speciality-specific sessions with a full day 2nd ERAS® Society World Congress in paediatrics and low income countries, as well as sessions on cardiac, orthopaedics, urology, gynaecology and nursing & AHP.

The Scientific Programme began on Thursday 2nd May and following addresses by both the ERAS® Chairman Professor Olle Ljungqvist progress on the new ERAS® Society Textbook was presented. Professor Nader Francis (Congress President), delivered the Presidential Address “The Global Perspective of Recovery”.  

Much of the day focussed on improving outcomes, an interactive session on the post anaesthetic care unit, inflammation, pain, and cutting edge advances with an undoubted highlight  being The Henrik Kehlet lecture, brilliantly delivered by Professor David Jayne from Leeds, UK, entitled “Does New Technology Improve Surgical Outcomes?” In addition, it is uplifting to see high ongoing high quality new research, with presentations of the best six abstracts.

The final day, Friday 3rd May, focussed on patient partnership,  “where are the problems? ” and current dilemmas. A popular session was “whose patient is it anyway” with two surgeons and two anaesthetists debating with a blend of intellect and humour a topical issue. The prestigious Ken Fearon Lecture entitled “Reducing Variation to Improve Outcome” given by Professor Rupert Pearse from London, UK, was a fantastic analysis of the importance of consistent care. Six excellent rapid-fire presentations were also delivered.


The congress ended with presentation of prizes as follows:

Rapid fire prize (€200):
OR09 – R Pickens – Vertical Compliance: A novel method of reporting patient specific ERAS compliance for real-time risk assessment

Best oral presentations:

First prize (€500)

OR02 – K Rollins Goal directed fluid therapy using trans oesophageal Doppler in patients undergoing elective colorectal surgery: A meta-analysis of randomised controlled trials.

Second prize (€300)

OR01 – L Halliday Adherence to exercise during rehabilitation: The relationship with changes in fitness and post-operative pneumonia.


As always it is good to see familiar faces and meet new delegates. Of particular note is the fusion of new ideas, together with the friendliness and informality that enabled younger members to have a relaxed chat to some of our very well-known delegates.

Full details of the Congress and our sponsors can be found  here.  Also, follow us on twitter @ErasSociety, we have increased our followers by about 1000 from last year to nearly 2700. We had very good twitter activity with over 200 individuals sending over 1000 tweets and using #ERAS2019, in all reaching over a quarter of a million people! Finally keep an eye for photos from the Congress which will be posted on the website the coming months.

We offer our sincere thanks to all involved in the delivery of an outstanding meeting, in particular the Congress President Nader Francis and his organising Committee, as well as our organising committee, the speciality group chairs and the ERAS® executive committee. In addition, many thanks go to our sponsors and our excellent congress planers, MCI Suisse.

Already we are planning the 8th ERAS® World Congress and will update you all when the details are finalised. We can then very much look forward to welcoming you and your teams!


Professor  WJ Fawcett

May 2019

Update following the publication of the ERAS Guidelines for Cardiac Surgery

ERAS Colleagues,

We are pleased to share our:

Guidelines for Perioperative Care in Cardiac Surgery:  Enhanced Recovery After Surgery Society Recommendations published in JAMA Surgery.

Our release of this landmark manuscript was announced during the recent American Association for Thoracic Surgeons on May 4th.  It contains graded recommendations for 22 subjects that can be considered to enhance recovery after cardiac surgery and was endorsed by the Enhanced Recovery after Surgery Society®.   Upon publication in JAMA Surgery, it has been viewed over 15,000 times in the first 10 days, making this one of the most viewed articles ever in this journal. It has an Altmetric score placing it in the top 1% of “attention scores” of all published manuscripts.  We are very pleased it has been so well received, and thus wanted to share it with each of you.  You can download the article from JAMA surgery without cost here.

We would also like to share our latest ERAS Cardiac Newsletter.

Thank you for your interest and continued support of the non-profit ERAS® Cardiac Society.  We look forward to future collaboration, meetings, and publications. Please visit our website for updates and further information,

The Society for Enhanced Recovery After Cardiac Surgery (ERAS® Cardiac) mission is to optimize perioperative care of cardiac surgical patients through collaborative discovery, analysis, expert consensus, and dissemination of best practices.


Cheryl Crisafi, MSN, RN, CNL, ERAS Cardiac Clinical Coordinator


Daniel Engelman MD, FACS, President, ERAS® Cardiac

ERAS Society Guidelines for Cardiac Surgery – Now published and free to download

The ERAS Society are delighted that the “Guidelines for Perioperative Care in Cardiac Surgery – Enhanced Recovery After Surgery Society Recommendations” have recently been published in JAMA Surgery. Congratulations to Dr. Engelman and colleagues on their fine work and valuable contribution.

The guidelines are available for FREE download here 

Link to the ERAS Cardiac chapter website

The guidelines have been published alongside an accompanying invited commentary from Prof Olle Ljungqvist titled “Enhanced Recovery After Surgery—Knowing, Not Guessing” which can be accessed here

Guidelines for perioperative care in gynecologic/oncology – 2019 update

The ERAS Society is delighted to announce that the “Guidelines for perioperative care in gynecologic/oncology: Enhanced Recovery After Surgery (ERAS) Society recommendations—2019 update” have just been published in the International Journal of Gynecological Cancer (IJGC). The guidelines are FREE to download and are available here.

They are also listed on our guideline page with all of the other ERAS Guidelines.

The Role of Oral Antibiotic Preparation in Elective Colorectal Surgery

ERAS Society Scientific Chair: Professor Dileep Lobo

ERAS Society guidelines have recommended that mechanical bowel preparation (MBP) should not be used for patients undergoing colonic surgery and that it should be used selectively for patients undergoing rectal surgery. This has been based on the fact that mechanical bowel preparation on its own did not impact on morbidity and mortality in these patients when compared with no bowel preparation or rectal enema alone.

This new meta-analysis has looked at the impact of oral luminal antibiotic preparation (OAB) on outcome in patients undergoing colorectal surgery. It has analysed data from both cohort studies (12 studies, 63,080 participants) and randomised controlled studies (28 studies, 6,437 patients). Although the addition of cohort studies may be considered to weaken the strengths of the conclusions, there have been a number of recent large cohort studies and these cannot be ignored. One of the strengths of this analysis is that it includes only one of the many NSQIP studies that have used the same database with overlapping cohorts of patients. Separate analyses have been presented for cohort and randomised controlled studies.
The meta-analysis has shown that a combination of MBP+OAB versus MBP alone was associated with a significant reduction in surgical site infection rates, anastomotic leak, 30-day mortality, overall morbidity and development of postoperative ileus, with no difference in Clostridium difficile infection rates. When a combination of MBP+OAB was compared with OAB alone, no significant difference was seen in SSI or anastomotic leak rates, but there was a significant reduction in 30-day mortality, and incidence of postoperative ileus with the combination. The study also found that there is minimal literature available on the comparison between combined MBP+OAB versus no preparation, OAB alone versus no preparation and OAB versus MBP. Whilst evidence arising from large retrospective cohort and database studies suggests a strong positive benefit, these are tempered when evidence arising from randomised controlled trials alone is considered. However, the evidence from randomised controlled trials suggests a benefit from OAB preparation in terms of SSI, which represents a major source of morbidity and increased healthcare costs.

The study suggests a potentially significant role for OAB preparation, either in combination with MBP or alone, in the prevention of postoperative complications in elective colorectal surgery, and perhaps, this may need revisiting the ERAS guideline recommendations.

Click here for the article.

Professor Dileep Lobo
University of Nottingham, UK


Recovery after surgery: time to break with tradition

Nurses Section Chair: Angie Balfour, RN

A new article has just been published in the Nursing Standard featuring ERAS Society Nurse Section Chair, Angie Balfour.

Pearce ,L.(2018).Recovery after surgery: time to break with tradition. Nursing Standard, 33(6), 70-72.doi:10.7748/ns.33.6.70.s27

Click here for the full article