The importance of high compliance with all ERAS elements.

The importance of high compliance with all ERAS elements.

Gustafsson U; Hausel J; Thorell A; Ljungqvist O; Soop M; Nygren J; Enhanced Recovery After Surgery Study Group. Adherence to the Enhanced Recovery After Surgery Protocol and Outcomes After Colorectal Cancer Surgery. Arch Surg. 2011;146(5):571-577.

What is already known:

This is now a relatively old paper but it was one of the first large studies to highlight the importance of adherence to all the ERAS elements.

What this paper adds:

This is a large prospective cohort study from a single centre. It compared an earlier phase (2002-5) during which ERAS was poorly implemented with a more recent period (2005-7) during which the ERAS programme was reinforced and as such achieved significantly higher compliance with the protocol. They demonstrated fewer major complications, fewer debilitating postoperative symptoms and shorter length of stay. Multivariate analysis showed that preoperative carbohydrate loading and perioperative fluid restriction were independent predictors of postoperative outcomes.

Chris Jones, Guildford