Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Updates in Surgery
Published in: Updates in Surgery 4/2017

Open Access 01-12-2017 | Review Article

Best practice in major elective rectal/pelvic surgery: enhanced recovery after surgery (ERAS)

Authors: Josefin Segelman, Jonas Nygren

Published in: Updates in Surgery | Issue 4/2017

Login to get access

Abstract

Within traditional clinical care, the postoperative recovery after pelvic/rectal surgery has been slow with high morbidity and long hospital stay. The enhanced recovery after surgery program is a multimodal approach to perioperative care designed to accelerate recovery and safely reduce hospital stay. This review will briefly summarize optimal perioperative care, before, during and after surgery in this group of patients and issues related to implementation and audit.
Literature
1.
Kenig J, Richter P (2013) Definition of the rectum and level of the peritoneal reflection—still a matter of debate? Wideochir Inne Tech Maloinwazyjne 8(3):183–186PubMedPubMedCentral
2.
Lassen K, Soop M, Nygren J, Cox PB, Hendry PO, Spies C et al (2009) Consensus review of optimal perioperative care in colorectal surgery: enhanced recovery after surgery (ERAS) group recommendations. Arch Surg 144(10):961–969CrossRefPubMed
3.
Varadhan KK, Neal KR, Dejong CH, Fearon KC, Ljungqvist O, Lobo DN (2010) The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials. Clin Nutr 29(4):434–440CrossRefPubMed
4.
Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN et al (2013) Guidelines for perioperative care in elective rectal/pelvic surgery: enhanced recovery after surgery (ERAS®) society recommendations. World J Surg 37(2):285–305CrossRefPubMed
5.
Nygren J, Thacker J, Carli F, Fearon KC, Norderval S, Lobo DN et al (2012) Guidelines for perioperative care in elective rectal/pelvic surgery: enhanced recovery after surgery (ERAS®) society recommendations. Clin Nutr 31(6):801–816CrossRefPubMed
6.
Nygren J (2006) The metabolic effects of fasting and surgery. Best Pract Res Clin Anaesthesiol 20(3):429–438CrossRefPubMed
7.
Gustafsson UO, Ljungqvist O (2011) Perioperative nutritional management in digestive tract surgery. Curr Opin Clin Nutr Metab Care 14(5):504–509CrossRefPubMed
8.
Guenaga KF, Matos D, Wille-Jorgensen P (2011) Mechanical bowel preparation for elective colorectal surgery. Cochrane Database Syst Rev 9:CD001544
9.
Bretagnol F, Panis Y, Rullier E, Rouanet P, Berdah S, Dousset B et al (2010) Rectal cancer surgery with or without bowel preparation: the French GRECCAR III multicenter single-blinded randomized trial. Ann Surg 252(5):863–868CrossRefPubMed
10.
11.
Smith MD, McCall J, Plank L, Herbison GP, Soop M, Nygren J (2014) Preoperative carbohydrate treatment for enhancing recovery after elective surgery. Cochrane Database Syst Rev 8:CD009161
12.
Feldheiser A, Aziz O, Baldini G, Cox BP, Fearon KC, Feldman LS et al (2015) Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice. Acta Anaesthesiol Scand 60:289–334
13.
Scott MJ, Baldini G, Fearon KC, Feldheiser A, Feldman LS, Gan TJ et al (2015) Enhanced recovery after surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations. Acta Anaesthesiol Scand 59(10):1212–1231CrossRefPubMedPubMedCentral
14.
15.
Chen K, Cao G, Chen B, Wang M, Xu X, Cai W et al (2017) Laparoscopic versus open surgery for rectal cancer: a meta-analysis of classic randomized controlled trials and high-quality nonrandomized studies in the last 5 years. Int J Surg 39:1–10CrossRefPubMed
16.
17.
Denost Q, Rouanet P, Faucheron JL, Panis Y, Meunier B, Cotte E et al (2017) To drain or not to drain infraperitoneal anastomosis after rectal excision for cancer: the GRECCAR 5 randomized trial. Ann Surg 265:474–480
18.
Pereira Gomes Morais E, Riera R, Porfirio GJ, Macedo CR, Sarmento Vasconcelos V, de Souza Pedrosa A et al (2016) Chewing gum for enhancing early recovery of bowel function after caesarean section. Cochrane Database Syst Rev 10:CD011562PubMed
19.
Short V, Herbert G, Perry R, Atkinson C, Ness AR, Penfold C et al (2015) Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev (2):CD006506. doi:10.​1002/​14651858.​CD006506.​pub3
20.
Andersen HK, Lewis SJ, Thomas S (2004) Early enteral nutrition within 24 h of colorectal surgery versus later commencement of feeding for postoperative complications. Cochrane Database Syst Rev (4):CD004080. doi:10.​1002/​14651858.​CD004080.​pub2
21.
Kehlet H, Wilmore DW (2002) Multimodal strategies to improve surgical outcome. Am J Surg 183(6):630–641CrossRefPubMed
22.
Gramlich LM, Sheppard CE, Wasylak T, Gilmour LE, Ljungqvist O, Basualdo-Hammond C et al (2017) Implementation of enhanced recovery after surgery: a strategy to transform surgical care across a health system. Implement Sci IS 12(1):67CrossRefPubMed
23.
Segelman J, Nygren J (2014) Evidence or eminence in abdominal surgery: recent improvements in perioperative care. World J Gastroenterol 20(44):16615–16619CrossRefPubMedPubMedCentral
24.
Gustafsson UO, Hausel J, Thorell A, Ljungqvist O, Soop M, Nygren J et al (2011) Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg 146(5):571–577CrossRefPubMed
25.
Gustafsson UO, Oppelstrup H, Thorell A, Nygren J, Ljungqvist O (2016) Adherence to the ERAS protocol is associated with 5-year survival after colorectal cancer surgery: a retrospective cohort study. World J Surg 40:1741–1747
26.
Nygren J, Soop M, Thorell A, Hausel J, Ljungqvist O (2009) An enhanced-recovery protocol improves outcome after colorectal resection already during the first year: a single-center experience in 168 consecutive patients. Dis Colon Rectum 52(5):978–985CrossRefPubMed
27.
Branagan G, Richardson L, Shetty A, Chave HS (2010) An enhanced recovery programme reduces length of stay after rectal surgery. Int J Colorectal Dis 25(11):1359–1362CrossRefPubMed
Metadata
Title
Best practice in major elective rectal/pelvic surgery: enhanced recovery after surgery (ERAS)
Authors
Josefin Segelman
Jonas Nygren
Publication date
01-12-2017
Publisher
Springer Milan
Published in
Updates in Surgery / Issue 4/2017
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-017-0492-2

Other articles of this Issue 4/2017

Updates in Surgery 4/2017 Go to the issue

Original Article

Lessons learned from 300 consecutive pancreaticoduodenectomies over a 25-year experience: the “safety net” improves the outcomes beyond surgeon skills

Original Article

Continuous intraoperative neural monitoring in thyroid surgery: a Mexican experience

Letter to the Editor

ItSURG: a challenge for surgical research in Italy

Original Article

Abdominal paragangliomas: a quantitative prognostic score as predictive factor of the feasibility of the laparoscopic approach

Original Article

Laparoscopic repair of ventral/incisional hernias with the “Slim-Mesh” technique without transabdominal fixation sutures: preliminary report on short/midterm results

Original Article

To evaluate the efficacy of an acellular Flowable matrix in comparison with a wet dressing for the treatment of patients with diabetic foot ulcers: a randomized clinical trial