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Enhanced Recovery After Surgery (ERAS) Group Recommendations

Kristoffer Lassen, MD, PhD; Mattias Soop, MD, PhD; Jonas Nygren, MD, PhD; P. Boris W. Cox, MD; Paul O. Hendry, MBChB, MRCS; Claudia Spies, MD, PhD; Maarten F. von Meyenfeldt, MD, PhD; Kenneth C. H. Fearon, MD, FRCS; Arthur Revhaug, MD, PhD; Stig Norderval, MD, PhD; Olle Ljungqvist, MD, PhD; Dileep N. Lobo, DM, FRCS; Cornelis H. C. Dejong, MD, PhD; for the Enhanced Recovery After Surgery (ERAS) Group

Arch Surg. 2009;144(10):961-969.

Objectives  To describe a consensus review of optimal perioperative care in colorectal surgery and to provide consensus recommendations for each item of an evidence-based protocol for optimal perioperative care.

Data Sources  For every item of the perioperative treatment pathway, available English-language literature has been examined.

Study Selection  Particular attention was paid to meta-analyses, randomized controlled trials, and systematic reviews.

Data Extraction  A consensus recommendation for each protocol item was reached after critical appraisal of the literature by the group.

Data Synthesis  For most protocol items, recommendations are based on good-quality trials or meta-analyses of such trials.

Conclusions  The Enhanced Recovery After Surgery (ERAS) Group presents a comprehensive evidence-based consensus review of perioperative care for colorectal surgery. It is based on the evidence available for each element of the multimodal perioperative care pathway.

Author Affiliations: Department of Gastrointestinal Surgery, University Hospital Northern Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway (Drs Lassen, Revhaug, and Norderval); Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Grafton, Auckland, New Zealand (Dr Soop); Department of Surgery, Ersta Hospital (Dr Nygren), Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet (Dr Nygren), and Division of Surgery, Karolinska Institutet, CLINTEC, Karolinska University Hospital Huddinge (Dr Ljungqvist), Stockholm, Sweden; Departments of Anaesthesiology and Pain Therapy (Dr Cox) and Surgery and NUTRIM (Drs von Meyenfeldt and Dejong), Maastricht University Medical Centre, Maastricht, the Netherlands; Department of Clinical and Surgical Sciences, Royal Infirmary of Edinburgh, Edinburgh, Scotland (Drs Hendry and Fearon); Department of Anaesthesiology and Intensive Care Medicine, Campus Charité Mitte and Campus Virchow-Klinikum, Charité Universitaetsmedizin Berlin, Berlin, Germany (Dr Spies); and Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham, England (Dr Lobo).

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