Enhanced Recovery After Surgery: A Review
Ljungqvist O, Scott M, Fearon KC. Enhanced Recovery After Surgery: A Review. JAMA Surgery. Epub January 11th 2017.
This review, written by three members of the ERAS® executive committee, provides a great overview of how fast track or Enhanced Recovery has evolved. The rationale of ERAS® is discussed, its elements and the concept of multimodal care, with synergy between the individual elements of care, as well as the interplay between caregivers: surgeons, physicians, nurses, physiotherapists and dieticians.
The paper addresses how ERAS programmes are set up in individual institutions, underpinned by evidence based, procedure specific, guidelines and continuous audit. The ERAS® Society been at the forefront of worldwide implementation of ERAS®.
Whilst length of hospital stay may have been an early goal for patients treated within ERAS® programmes, we are now seeing other benefits in particular a reduction in complications and readmissions across a range of surgeries. This has resulted in considerable cost savings per patient. Excitingly, long term benefits of ERAS® are becoming evident in both orthopaedics and patients with colorectal cancer.
Since this prestigious review was written for JAMA Surgery, our friend, colleague and mentor, Professor Ken Fearon died, and this review provides a fitting testimony to his outstanding efforts, intellect and enthusiasm for the ERAS® programme.
Bill Fawcett, UK.