The Controversies of Mechanical Bowel and Oral Antibiotic Preparation in Elective Colorectal Surgery

Brief summary: After including the results of two recent randomised controlled trials, this updated meta-analysis suggests that oral antibiotics alone or a combination of mechanical bowel preparation and oral antibiotics is superior to no bowel preparation in patients undergoing colorectal surgery when surgical site infection and anastomotic leak rates are considered.

The article is available here.

Prof Dileep Lobo

Prof Ljungqvist presents ERAS at the Nordic Innovation Summit 2020

Professor Olle Ljungqvist joined colleagues at the National Nordic Museum’s “Nordic Innovation Summit 2020 presented by Ericsson”,  a virtual event held on May 14, 2020, to talk about ERAS.

There is a link below to watch the session

UPDATE – The 2020 Joint Congress of ERAS Society and ERAS USA has been postponed until 2021

The organizers of the 2020 Joint Congress of ERAS Society and ERAS USA have been closely monitoring updates and recommendations from the Centers for Disease Control and Prevention (CDC) and from the World Health Organization (WHO).  We have also been actively following travel advisories and restrictions placed on hospitals and institutions, and stay-at-home orders in countries around the world.  While we all had hoped to come together in New Orleans, Louisiana, USA this August for our Joint Congress, we firmly believe that putting the health, safety and wellbeing of our attendees, and their patients and families, comes first.  It is with heavy hearts that ERAS Joint Congress has made the difficult but necessary decision to postpone our 2020 Congress, and move it forward to July of 2021.

Full details including information on abstract submissions, registration, and refunds will be sent out shortly.  We appreciate your patience and understanding as we work through the best way to make this convenient for our members, attendees and industry partners.

Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery now Published!

Congratulations to Dr. Brindle and colleagues on the recent publication of the “Consensus Guidelines for Perioperative Care in Neonatal Intestinal Surgery: Enhanced Recovery After Surgery (ERAS®) Society Recommendations”.

The paper has been published open access in the World Journal of Surgery, and is available here.

ERAS® Society USA Chapter and Office of National Drug Control Policy Webinar – Recording Now Available

Webinar on Enhanced Recovery After Surgery (ERAS): Medical education engagement to support safe prescribing for patients needing surgery

This webinar, which included prominent ERAS leaders including ERAS® USA President-Elect Dr. Michael Scott and ERAS® USA Past President Dr. Tonia Young-Fadok, was designed for health care leaders to learn about the National Drug Control Strategy and how the surgical community has an important role in optimal surgical outcomes as well as safe prescribing education, prevention, and referral to addiction services. The Office of National Drug Control Policy (ONDCP) with the assistance of ERAS USA have organized this webinar. The Public Health, Education and Treatment team hopes to utilize this webinar as an opportunity to communicate the Administration’s support for safe prescribing practices and the role of the entire health care community in leading the path in both prevention as well as treatment for those who need surgical care.

ERAS® Society Executive Committee Statement regarding surgery and anaesthesia during the COVID-19 pandemic

The COVID-19 pandemic is sweeping across the world and affecting all of us gravely. It impacts upon surgical practice substantially by necessitating cancellation or postponement of the majority of elective operations to create capacity for the management of patients in need of treatment for COVID-19. Several countries, surgical societies, national associations and journals have published guidelines on how to manage these patients, many of which can be found with a simple internet search using “COVID-19 Guidelines for surgery”. There are also case series soon to be published showing how units have managed their patients during this crisis. The ERAS® Society chooses not to publish guidelines on this topic but rather point to the fact that for the patients who do undergo elective surgery, it is now more important than ever before to implement ERAS® pathways, given the increased importance to avoid complications, intensive care admission and to have patients in a condition to leave the hospital as soon as possible.

It must also be highlighted that at present there is little or no scientific evidence to base recommendations for the treatment of COVID-19 patients undergoing surgery, but at this point in the development of knowledge it is relying on opinion and use of information from other pathogens in different situations that will shape any future guidelines.

Professor Olle Ljungqvist
Professor Gregg Nelson
Dr Hans De Boer
Professor Nicolas Demartines
Professor Dileep Lobo
Professor Michael Scott
Professor William Fawcett
Ms Angie Balfour

Over 103,000 views of the ERAS Society and ERAS Cardiac Society Guidelines

Guidelines for Perioperative Care in Cardiac Surgery Enhanced Recovery After Surgery Society Recommendations

JAMA Surgery has reported that the ERAS Society and ERAS Cardiac Society Guidelines were the highest viewed paper in 2019 in the journal. JAMA Surgery is the first surgical journal to reach double digits in impact factor with 10.7 and is now the worlds highest ranking surgical journal! The views exceeded 103,000 with the second scoring paper at around 31,000. We congratulate Dan Engelamn and the entire team behind this milestone achievement reflecting the impact and importance of ERAS as it is moving across different specialties.

Read the full editorial here

Textbook now available to order! ERAS – A Complete Guide to Optimizing Outcomes

The text book “Enhanced Recovery After Surgery A Complete Guide to Optimizing Outcomes” edited by Prof Olle Ljungqvist, Prof Nader Francis, and Prof Richard Urman is now available to order on the Springer website.

The book Provides a broad and comprehensive overview of ERAS with expert opinions from leaders in the field regarding elements of care that are both generic and specific to various surgeries First comprehensive, authoritative book on the subject that covers the patient journey through such a program, commencing with optimization of the patient’s condition, patient education, and conditioning of their expectations Discusses metabolic response to surgery, anaesthetic contributions, and optimal fluid management after surgery, providing examples of ERAS pathways and practical tips on post-operative pain control, feeding, mobilization, and criteria for discharge Helps an existing user of ERAS care and centers with established programs by outlining causes of deviation and failure and suggesting modifications that may be necessary

Save the date – International Surgical Week (ISW) 2021 – Aug 29-Sep 2, 2021, Kuala Lumpur, Malaysia

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Engaging and insightful, the International Surgical Week (ISW) 2021 will be unlike any other meeting. Offering scientific excellence in the field of surgery at an affordable price, the event will bring together many of the world’s leading experts. ISW 2021 will also provide a platform for scientific and clinical working groups where they can collaborate to establish the foundations for future diagnostic and surgical challenges, and discuss novel approaches and standards, facilitating progress towards real-time, patient-oriented solutions.

For more information visit www.isw2021.org or visit The International Society of Surgery website www.iss-sic.com

Updated ERAS Society guidelines for Pancreatoduodenectomy now published!

The new “Guidelines for Perioperative Care for Pancreatoduodenectomy: Enhanced Recovery After Surgery (ERAS) Recommendations 2019” have just been published in the World Journal of Surgery. This is an update following the  first published guidelines in 2012, and is based on the best available evidence and on expert consensus.

Guidelines for Perioperative Care in Cardiac Surgery – Now over 107,000 views/downloads

Guidelines for Perioperative Care in Cardiac Surgery Enhanced Recovery After Surgery Society Recommendations

We are delighted to report that the “Guidelines for Perioperative Care in Cardiac Surgery Enhanced Recovery After Surgery Society Recommendations” published in JAMA Surgery in August, 2019, have now received over 107,000 views/downloads since its release. Further to this, the manuscript has achieved an Altimetric attention score of 322, which makes it one of the top research outputs scored by this group. JAMA Surgery is the highest impact factor peer reviewed surgical journal, with an impact factor of 10.668, and this article was the most viewed manuscript in 2019.

We are pleased that our contribution has garnered so much attention from our peers in cardiac surgery, cardiac anesthesia, critical care, and nursing. We look forward to continuing to standardize best practice surrounding the perioperative care of cardiac surgical patients through expert consensus, review of the literature, and open communication.

Congratulations to the ERAS® CARDIAC Board of Directors and Authors

Letter from the ERAS Society Chairman – Reviewing 2019 and Previewing 2020

Chairman: Professor Olle Ljungqvist

2019 – Thank you all for another great ERAS® Society year

It is with great happiness and pride that I can summarize that 2019 has been yet another year of great developments for ERAS® and the ERAS® Society.

This year the ERAS® Society Guidelines surpassed 4,000 citations in PubMed, and when these guidelines are put in use, several reports from different surgeries also show that both short- and long-term outcomes improve. The interest in ERAS® is mirrored by the number of ERAS® publications that are constantly growing; up from around 40 15 years ago to over 600 in the last year. ERAS® makes a big difference in outcomes and this is why ERAS® is a top subject in surgery and anesthesia.

The ERAS® Society is very active in a range of different areas, and I am proud to mention just a few highlights that have been accomplished by a large number of great leaders, experts and collaborators around the globe:

Guidelines: This year ERAS® Society Guidelines broke records in downloads in JAMA Surgery (highest impact journal in surgery) with the Guideline on Cardiac Surgery, and the update of the Colorectal Guideline was a big hit. We were also happy to have just released the Guideline on Hip and Knee replacement surgery on-line. This year the Society also published a guideline for ERAS® Society Guidelines outlining the history behind them and how they have developed into the methodology used currently.

Joining forces: During 2019 we established and strengthened bonds with major Anesthesia Societies – the Brazilian and the European Societies of Anaesthesiology. With these two prominent Societies we will be able to bring the true ERAS® to many more hospitals globally.

Implementation worldwide: Several countries in LATAM are joining the ERAS® Society and ERAS® LATAM, and in countries already with Centers of Excellence present, we are seeing them now training other hospitals in their countries. In Brazil a total of seven new hospitals are engaged in an ERAS® Implementation Program with the ambition to spread it across the country in a collaborative manner with the Brazilian Society of Anesthesiology. In the US, Mayo Clinic and Brigham and Women’s Hospital are now trained as Centers of Excellence and starting to help other units implement ERAS® across the USA. In Asia the first hospital in India is in training, as is the first in Dubai, with more countries joining early next year; Taiwan and Thailand are next in line to follow Singapore, Philippines and Vietnam. In Europe new units across the continent are being trained and in South Africa plans are laid out for spreading ERAS® inside and outside the country.

Congresses and meetings: This year’s main event was the 7th ERAS® World Congress successfully run with ERASUK in Liverpool, UK. An excellent program was held over 3 days with almost 600 delegates from over 70 countries. The 1st ERAS®ASIA congress was held in Singapore to meet the growing interest and demand for ERAS® in this part of the world. More than 200 delegates covering most countries in Asia made this returning event a huge success. In addition, numerous ERAS® sessions and presentations have been part of just about every major international and national congress around the world; many of these presentations are delivered and sessions organized by ERAS® Society members and collaborators. Lastly, in several countries national ERAS® Society Chapters have held congresses and events.

What is in line for 2020?

Next year’s main event will be the 8th ERAS World Congress, in collaboration with ERAS®USA in New Orleans, USA August 26-28. Several local or regional events will take place across the globe – keep an eye on the ERAS® Society website for updates. The ERAS® Society Textbook will be released by Springer, USA during the first quarter of 2020. The title is: Enhanced Recovery After Surgery – A Complete Guide to Optimizing Outcomes. The textbook has 65 chapters written by world leaders in ERAS®, covering all you need to know about ERAS®.

The ERAS® Society will launch a formal membership early next year. Membership will provide a series of benefits in addition to being part of an international multi-professional and multi-disciplinary medical society that is changing the course of surgery and anesthesia: – On line subscriptions to 4 leading journals: World Journal of Surgery, European Journal of Anaesthesiology, Current Opinion in Anesthesiology, and Current Opinion in Critical Care – ERAS® Society textbook: Discounted price on the textbook (released during the 2st quarter of 2019) from Springer – all you need to know about ERAS® – 65 chapters, written by world leading authors. – Congress fee rebate: Reduced registration at the 8th World Congress in New Orleans. Details to be announced on the website shortly.

Guidelines: new and updated guidelines are under way for 2021 Let me thank all of the excellent collaborators and co-workers involved in the ERAS® Society who have made these tremendous successes possible and who have dedicated their precious time and knowledge to help move ERAS® forward with the goal to improve outcomes for patients. I wish all of you the very best for the holidays and the New Year. It has been an honor and privilege to serve as the Chairman of this formidable group of people working for the ERAS®Society.

Sincerely,

Olle Ljungqvist

Chairman ERAS® Society Executive Committee