Report on the 6th ERAS® World Congress

The 6^th ERAS® Society World Congress was held at the Clarion Sign Hotel, Stockholm, Sweden, from the 23^rd – 25^th May 2018.  Enjoying beautiful spring sunshine, the Congress was our most successful to date. The international standing of the Society was confirmed attracting 585 delegates worldwide. Whilst the majority came from Europe (73%), over 11% of delegates came from both North America and Asia, with smaller numbers from Oceania (2%), South America (2%), and Africa (<1%). Locally we had very strong support, attracting 137 Swedish delegates.

This was easily the best attended Congress to date with a nearly 50% increase in numbers from Lyon in 2017 (393) and Lisbon in 2016 (389). We also surpassed the numbers in Washington in 2015 (492) – which was a combined meeting with EBPOM and ASER. These delegate numbers reflect the growing worldwide interest for ERAS®. We also had 13 abstracts selected for oral presentation and 102 poster presentations (all published in Clinical Nutrition ESPEN 2018;25:166-209 with a link to the abstracts here).

On 23^rd May, there was the ever-popular ERAS® course where delegates learnt about the relevant pathophysiology and perspectives from different healthcare professionals – surgeons, anaesthesiologists and nursing.  In addition, clinical audit and speciality-specific areas were covered. There were also a number of other symposia – cardiac surgery, women’s health/gynecology, urology, nursing and AHP meeting during this first afternoon. A major highlight of the day was the official joining of ERAS® Cardiac Surgery to the ERAS® Society.

The Scientific Programme began on 24^th May and following addresses by both the ERAS® Chairman,  Professor Olle Ljungqvist and Professor Anders Thorell (Congress Chairman), new frontiers were discussed. A highlight was The Ken Fearon lecture, delivered by Professor Luca Gianotti, from Monza, entitled “Critical aspects of clinical trials in surgery and ERAS”.

The majority of this day focussed on new ERAS® frontiers (thoracic surgery, emergency laparotomy, pediatric surgery and cardiac surgery), perioperative anaemia, the challenging ERAS patient (diabetes, mobilisation with paraplegia, dementia and substance abuse) and the difficult problem of postoperative ileus also discussed. A popular session was the interactive discussion about complex cases. The day ended with presentations of the best six abstracts.

The final day’s highlight was The Henrik Kehlet lecture, delivered by Professor Pierre-Alain Clavien from Zurich, entitled “New concept of benchmarking in surgery”, tracing the evolution of Clavien-Dindo classification into the Comprehensive Complication Index (CCI).  Other sessions included experts discussing epidurals versus wound catheters, delayed gastric emptying, bowel preparation, and barriers to the adoption of ERAS® worldwide. One area that has received little attention to date is what to do with the ERAS® patient after discharge from hospital? An entire session was devoted to this with presentations on nutrition, thromboprophylaxis, exercise training and structured nursing follow-up. The concepts of ERAS® and survival – both long and short term – and patient partnership were also discussed. Seven excellent rapid-fire presentations were also delivered.

The congress ended with presentation of the best paper prize to:

THE EFFECTS OF BETA-BLOCKER THERAPY ON EARLY MORTALITY FOLLOWING EMERGENCY COLON CANCER SURGERY 

Rebecka Ahl ¹, Peter Matthiessen ^{1, 2}, Xin Fang ³, Yang Cao ^{1, 3}, Gabriel Sjölin ^{1, 2}, Rickard Lindgren ², Olle Ljungqvist ^{1, 4}, Shahin Mohseni ^{1, 2}

1 School of Medical Sciences, Örebro University, 2 Department of Surgery, Örebro University Hospital, Örebro, 3 Institute of Environmental Medicine, 4 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

And the best rapid fire presentation to:

RISK FACTORS FOR DELAYED GASTRIC EMPTYING AFTER PANCREATICODUODENECTOMY AND NEED FOR ENTERAL FEEDING ACCESS IN THE ERAS® ERA

William B. Lyman ¹, Michael Passeri ², Russell C. Kirks ¹, Allyson Cochran ², John B. Martinie ², Dionisios Vrochides ², Erin H. Baker ², David A. Iannitti ².

1 Department of Surgery, Carolinas Medical Center, Charlotte, United States; 2 Division of HPB Surgery, Carolinas Medical Center, Charlotte, United States

What were the highlights? The two keynote lectures were, as always, enthralling. The wealth of excellent research is always heartening as superb worldwide talent is taking ERAS® forward. The satellite symposia? The ERAS® Course? The many excellent lectures? The joining of ERAS® Cardiac Society?

Full details of the Congress and our sponsors can be found here. Also, follow us on twitter @ErasSociety, we have increased our followers to nearly 1700! We had very good twitter activity with over 175 individuals sending over 800 tweets and using #ERAS2018, in all reaching nearly a quarter of a million people! Finally keep an eye for interviews and 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 Anders Thorell and his local organising Committee, the speciality group chairs and the ERAS® executive committee. In addition many thanks go to our sponsors and our excellent congress planners, MCI Suisse.

Already we are planning the 7^th ERAS® Society World Congress which will be held at the Liverpool Arena and Convention Centre (ACC),UK, May 1-3, 2019. Please make a note of the date and we very much look forward to welcoming you and your teams there!

Dr WJ Fawcett

June 2018