BACKGROUND: Multimodal care or Enhanced Recovery after Surgery (ERAS) protocols are gaining popularity in order to modify surgical stress responses after colonic resection. However, these protocols are not straightforward to implement as peri-operative care is varied. We aimed to identify areas that may need attention in order to successfully change practice. METHOD: The literature was reviewed for current practice, methods and issues in implementing ERAS. Based on this and our own experience we discuss several important areas that need particular attention in developing and sustaining an ERAS program. RESULTS: International surveys have shown that current peri-operative care in colorectal resection is not evidence based. Important aspects of the ERAS philosophy including patient counselling, teamwork and attitude change are identified and discussed. CONCLUSION: Implementing evidence-based peri-operative care into practice is challenging. Barriers to multimodal recovery pathways should be addressed.
BACKGROUND: Multimodal care or Enhanced Recovery after Surgery (ERAS) protocols are gaining popularity in order to modify surgical stress responses after colonic resection. However, these protocols are not straightforward to implement as peri-operative care is varied. We aimed to identify areas that may need attention in order to successfully change practice. METHOD: The literature was reviewed for current practice, methods and issues in implementing ERAS. Based on this and our own experience we discuss several important areas that need particular attention in developing and sustaining an ERAS program. RESULTS: International surveys have shown that current peri-operative care in colorectal resection is not evidence based. Important aspects of the ERAS philosophy including patient counselling, teamwork and attitude change are identified and discussed. CONCLUSION: Implementing evidence-based peri-operative care into practice is challenging. Barriers to multimodal recovery pathways should be addressed.
Authors: Marion van der Kolk; Mark van den Boogaard; Femke Becking-Verhaar; Hettie Custers; Hans van der Hoeven; Peter Pickkers; Kees van Laarhoven Journal: J Gastrointest Surg Date: 2017-06-06 Impact factor: 3.452
Authors: Manuel Alcántara-Moral; X Serra-Aracil; M J Gil-Egea; M Frasson; B Flor-Lorente; E Garcia-Granero Journal: Int J Colorectal Dis Date: 2014-01-17 Impact factor: 2.571
Authors: Evan Stearns; Margaret A Plymale; Daniel L Davenport; Crystal Totten; Samuel P Carmichael; Charles S Tancula; John Scott Roth Journal: Surg Endosc Date: 2017-12-21 Impact factor: 4.584
Authors: Riccardo Lemini; Aaron C Spaulding; James M Naessens; Zhuo Li; Amit Merchea; Julia E Crook; David W Larson; Dorin T Colibaseanu Journal: Int J Colorectal Dis Date: 2018-07-21 Impact factor: 2.571