Essential Elements for Enhanced Recovery After Intra-Abdominal Surgery.

Area of Science:

• Perioperative Medicine
• Surgical Care Improvement
• Evidence-Based Practice

Background:

• Enhanced recovery pathways (ERAS) offer a structured approach to perioperative care.
• Traditional hospital models often operate in silos, hindering coordinated patient care.
• A multidisciplinary ERAS team is crucial for planning and executing interventions.

Purpose of the Study:

• To review evidence-based enhanced recovery pathways for intra-abdominal surgeries.
• To identify common ERAS elements that yield the best outcomes.
• To provide generalized guidelines applicable to all intra-abdominal procedures.

Main Methods:

• Searches of PubMed and the worldwide web using keywords: "ERAS," "Enhanced Recovery After Surgery," and "protocol."
• Selection of manuscripts focusing on intra-abdominal procedures published between 2012 and 2017.
• Categorization of ERAS interventions into preoperative, perioperative, and postoperative phases.

Main Results:

• ERAS philosophy emphasizes breaking down hospital silos for optimized perioperative patient journeys.
• Interventions are categorized into preoperative, perioperative, and postoperative phases, coordinated by a multidisciplinary team.
• Common ERAS elements providing the best outcomes for intra-abdominal procedures were identified.

Conclusions:

• Enhanced recovery pathways provide a framework for optimal perioperative care in intra-abdominal surgery.
• Evidence-based interventions, applied individually, improve patient outcomes.
• Generalized ERAS protocols can be developed for a wide range of intra-abdominal procedures.