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Updated: Jan 8, 2026

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Post-surgical diets in the ERAS protocol: D-ERAS scoping review.

Camilla Fiorindi1, Pauline Raoul2, Valentina Moretto3

  • 1Department of Allied Health Professions, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy. camilla.fiorindi@unifi.it.

European Journal of Clinical Nutrition
|December 18, 2025
PubMed
Summary
This summary is machine-generated.

Enhanced Recovery After Surgery (ERAS) guidelines recommend early oral feeding (EOF), but this review found many studies start feeding later than advised. Protocols lack standardization, hindering adherence to ERAS for optimal patient recovery.

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Area of Science:

  • Surgical Nutrition
  • Enhanced Recovery Pathways
  • Postoperative Care

Background:

  • Enhanced Recovery After Surgery (ERAS) programs incorporate early oral feeding (EOF) to accelerate patient recovery.
  • Current ERAS guidelines suggest resuming oral intake within 24 hours post-surgery but lack specifics on diet progression and composition.

Purpose of the Study:

  • To conduct a scoping review of postoperative oral feeding protocols (OFPs) used in various abdominal surgeries.
  • To analyze adherence to ERAS recommendations within existing OFPs and identify inconsistencies.

Main Methods:

  • A comprehensive literature search was performed using PubMed and Scopus databases.
  • Sixty-eight articles detailing OFPs for esophageal, gastric, hepatobiliary, pancreatic, colorectal, urologic, and gynecologic surgeries were included and synthesized thematically.

Main Results:

  • Many included studies initiated oral feeding later than the ERAS-recommended 24-hour timeframe.
  • Protocols often commenced with liquids and progressed slowly, even for surgeries where solid food initiation is encouraged.
  • Significant inconsistencies and a lack of standardized terminology regarding diet composition (energy, nutrients, food types, meal frequency) were identified across studies.

Conclusions:

  • There is considerable non-adherence to ERAS guidelines regarding the timing and progression of postoperative oral feeding.
  • The lack of standardized OFPs and detailed dietary descriptions presents a barrier to implementing evidence-based nutritional strategies within ERAS pathways.