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Integration of Precision Medicine into ERAS Pathways: A Conceptual Framework, Current Feasibility and Challenges
Berkan Aliev1,2, Boyko Atanasov3,4
1Department of Anesthesiology, Emergency and Intensive Care Medicine, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria.
Journal of Personalized Medicine
|July 27, 2026
Summary
Enhanced Recovery After Surgery (ERAS) pathways improve surgical care, but patient recovery varies. Precision medicine offers personalized ERAS protocols by integrating patient-specific data, but tools need validation for wider use.
Area of Science:
- Perioperative Medicine
- Surgical Outcomes
- Precision Medicine
Background:
- Enhanced Recovery After Surgery (ERAS) pathways standardize evidence-based perioperative care.
- Significant variability in postoperative recovery persists despite ERAS implementation.
- Heterogeneity in recovery is due to clinical risk, biological response, and uncaptured factors.
Purpose of the Study:
- To examine the role of precision medicine in refining ERAS pathways.
- To propose a conceptual model for 'precision ERAS'.
Main Methods:
- Narrative review of precision medicine tools in perioperative practice.
- Analysis of challenges and future directions for integrating personalized data into ERAS.
Main Results:
- Precision medicine can enhance ERAS by integrating patient-specific data for risk assessment and intervention.
- Current precision medicine tools lack sufficient validation and face implementation challenges (cost, data integration, workflow, equity).
Conclusions:
- Precision medicine holds promise for tailoring ERAS protocols to individual patient needs.
- Further prospective validation and pragmatic implementation studies are crucial for clinical utility.
- A 'precision ERAS' model combines standardized care with individualized interventions based on risk and phenotype.
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