Guidelines for Perioperative Care in Esophagectomy: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2018 Oct 3

PMID 30276441

Citations 174

Authors

Donald E Low

William Allum

Giovanni De Manzoni

Lorenzo Ferri

Arul Immanuel

MadhanKumar Kuppusamy

Simon Law

Mats Lindblad

Nick Maynard

Joseph Neal

C S Pramesh

Mike Scott

B Mark Smithers

Valerie Addor

Olle Ljungqvist

Affiliations

Soon will be listed here.

Abstract

Introduction: Enhanced recovery after surgery (ERAS) programs provide a format for multidisciplinary care and has been shown to predictably improve short term outcomes associated with surgical procedures. Esophagectomy has historically been associated with significant levels of morbidity and mortality and as a result routine application and audit of ERAS guidelines specifically designed for esophageal resection has significant potential to improve outcomes associated with this complex procedure.

Methods: A team of international experts in the surgical management of esophageal cancer was assembled and the existing literature was identified and reviewed prior to the production of the guidelines. Well established procedure specific components of ERAS were reviewed and updated with changes relevant to esophagectomy. Procedure specific, operative and technical sections were produced utilizing the best current level of evidence. All sections were rated regarding the level of evidence and overall recommendation according to the evaluation (GRADE) system.

Results: Thirty-nine sections were ultimately produced and assessed for quality of evidence and recommendations. Some sections were completely new to ERAS programs due to the fact that esophagectomy is the first guideline with a thoracic component to the procedure.

Conclusions: The current ERAS society guidelines should be reviewed and applied in all centers looking to improve outcomes and quality associated with esophageal resection.

Citing Articles

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Feeding tube self-management experience of patients at home after discharge following esophageal cancer surgery.

Miao G, You Q, Feng X, Chu J, Li J, Cai P World J Gastrointest Surg. 2025; 17(2):100197.

PMID: 40061993 PMC: 11885994. DOI: 10.4240/wjgs.v17.i2.100197.

Incidence trends of surgical complications after oesophagectomy for oesophageal cancer: a population-based, nationwide cohort study in Finland over 30 years.

Sirvio V, Rasanen J, Helminen O, Helmio M, Huhta H, Kallio R World J Surg Oncol. 2025; 23(1):59.

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The implementation of eras in Belgian esophageal surgery centers.

Dorreman Y, Vanommeslaeghe H, Pattyn P, Bertrand C, Depypere L, Van Veer H Updates Surg. 2025; .

PMID: 39921804 DOI: 10.1007/s13304-025-02063-x.

Association Between Early Mobilization and Postoperative Pneumonia Following Robot-assisted Minimally Invasive Esophagectomy in Patients with Thoracic Esophageal Squamous Cell Carcinoma.

Nozawa Y, Harada K, Noma K, Katayama Y, Hamada M, Ozaki T Phys Ther Res. 2025; 27(3):121-127.

PMID: 39866387 PMC: 11756562. DOI: 10.1298/ptr.E10293.

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