Guide to Enhanced Recovery for Cancer Patients Undergoing Surgery

Excerpt

Enhanced Recovery After Surgery (ERAS) has gained popularity in thoracic surgery, especially in the context of lung cancer resections. ERAS pathways are protocolized, perioperative care bundles that are designed to improve outcomes.1 For example, this includes interventions such as multimodal, opiate-sparing pain control and prompt, protocolized chest tube removal in the perioperative period. While enhancing outcomes are and should be the primary aim of ERAS, several secondary benefits have also been realized, particularly related to the cost savings associated with accelerated recovery and early discharge.2 One challenge to widespread ERAS implementation is that individual components tend to be heterogeneous, varying significantly across hospitals and providers. Further, most studies to date have been small and retrospective, often with historical controls, a caveat to evidence-based implementation.3 Another challenge is measuring the impact of individual ERAS components. While single ERAS items may have a modest impact when studied in isolation, combining several elements together often has synergistic effects, leaving some uncertainty to which elements are most beneficial.4 Nevertheless, and despite these evidential shortcomings, numerous ERAS items specific to lung cancer surgery have emerged for efficient, patient-centered care.5 …