Too fast or too slow?: Considerations in the era of enhanced recovery and FAST Track for upper GI surgery

Current ERAS recommendations in UGI surgery are often based on low levels of evidence. While the concepts of enhanced recovery are very promising and should be supported, recent studies have also shown that there might be a need for slowing down for some aspects and components in the era of wide spreading FAST track concepts. Therefore, more high-quality studies are needed to identify key perioperative factors that have a critical impact on postoperative outcomes in UGI surgery, while also not subjecting patients to unnecessary interventions. Importantly, the proportionality, cost-effectiveness, and efficacy of any measures should be critically reviewed to avoid overtreatment and to enhance recovery.