The Development of Enhanced Recovery After Surgery Across Surgical Specialties

Area of Science:

• Surgical Outcomes Research
• Evidence-Based Medicine
• Healthcare Quality Improvement

Background:

• Enhanced Recovery After Surgery (ERAS) principles are increasingly adopted across various surgical disciplines.
• ERAS aims to reduce length of stay without compromising patient safety or increasing readmissions.
• Literature exists on ERAS implementation in general, thoracic, urologic, and gynecologic surgery.

Purpose of the Study:

• To review and summarize the literature on ERAS implementation across multiple surgical specialties.
• To assess the extent of ERAS adoption and reported outcomes in key studies, systematic reviews, and meta-analyses.
• To identify common benefits, challenges, and future directions for ERAS protocols.

Main Methods:

• Literature review of studies on ERAS implementation.
• Focus on colorectal, general, thoracic, urologic, and gynecologic surgery.
• Summarization of ERAS implementation extent and reported outcomes.

Main Results:

• ERAS implementation is not uniform across surgical specialties but consistently improves patient outcomes.
• Reduced length of stay is the most common benefit; complication and readmission rates are notably decreased in colorectal surgery.
• Studies are increasingly measuring nuanced postoperative well-being, with growing efforts in standardization and quality control.

Conclusions:

• Challenges persist in ERAS study and execution, particularly in controlling adherence and standardizing protocols.
• Future ERAS investigations should focus on post-discharge quality of life, return to work/independent living, and adjuvant treatment adherence.
• The practice and benefits of ERAS are expected to evolve with continued research and refinement.