Adherence to the Enhanced Recovery After Surgery Protocol and Outcomes After Colorectal Cancer Surgery

Abstract

Although interventions within enhanced recovery after surgery (ERAS) or fast-track programs have been shown to improve postoperative recovery in colorectal surgery,^1-4 universal implementation has not yet occurred.⁵ One reason could be that ERAS programs are considered complex and resource demanding.⁶ Another is that the ERAS concept as such possibly appears elusive because the relative contribution of each intervention in the program remains uncertain. Nevertheless, some of the elements in the ERAS program, such as omission of routine bowel preparation for colonic resections, no routine use of postoperative drains, early removal of nasogastric tubes, and early feeding and mobilization, have already been incorporated in traditional care.^5,7 Recently, a modified fast-track protocol (RAPID) with only 4 interventions,⁸ instead of 20 in the ERAS program,^9,10 was also presented.