High compliance with ERAS elements can have huge long-term benefits.  

High compliance with ERAS elements can have huge long-term benefits.  

Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O. Adherence to the ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery: A Retrospective Cohort Study. World J Surg. 2016 Jul;40(7):1741-7.

What is already known:

ERAS protocols have mostly focused on the short-term outcomes such as length of hospital stay, morbidity or hospital costs. This is one of the few papers that have started to look at longer term outcomes. We know from Khuri et al in 2005, that perioperative complications can have a dramatic effect on long term survival (in both cancer and non-cancer surgery). We know that ERAS pathways can reduce morbidity but we don’t know what long-term effect this reduction of morbidity can have.

What this paper adds:

This is potentially a hugely important paper. In this Swedish single centre study with over 900 patients, they compared adherence of ERAS elements with 5-year overall and cancer specific survival. They found that patients with >70% adherence the risk of 5-year cancer-specific survival was lowered by 42%. And importantly avoiding fluid overload and early oral intake were shown as independent predictors of increased 5-year survival.

Chris Jones, Guildford