The Latest Results and Future Directions of Research for Enhanced Recovery after Surgery in the Field of Colorectal Surgery
Enhanced recovery after surgery (ERAS) aims to promote postoperative recovery in patients by minimizing the surgical stress response through evidence-based multimodal interventions. In 2023, updated clinical practice guidelines were publish...
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| Format: | Article |
| Language: | English |
| Published: |
Ewha Womans University College of Medicine
2023-12-01
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| Series: | The Ewha Medical Journal |
| Subjects: | |
| Online Access: | http://www.e-emj.org/archive/view_article?pid=emj-46-s1-23 |
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| Summary: | Enhanced recovery after surgery (ERAS) aims to promote postoperative recovery in
patients by minimizing the surgical stress response through evidence-based
multimodal interventions. In 2023, updated clinical practice guidelines were
published in North America, potentially superseding the most recent guidelines
previously announced at the ERAS Society in 2019. This review compares and
reviews these two guidelines to examine the principle of ERAS and items related
to colorectal surgery and to introduce the latest relevant study results
published within the last 5 years. In the pre-hospitalization stage, the concept
of pre-hospitalization is emphasized; this involves checking and reinforcing the
patient’s nutritional status and physical functional status before
surgery. In the preoperative stage, large-scale studies have prompted a change
in the recommendation of mechanical bowel preparation combined with oral
antibiotics in elective colorectal surgery. In the intraoperative stage,
laparoscopic surgery has become a widespread and important component of ERAS,
and more technologically advanced single-incision laparoscopic surgery and
robotic surgery are the focus of active research. Ileus-prevention items, such
as opioid-sparing multimodal pain management and euvolemic fluid therapy, are
recommended in the postoperative stage. The adoption of ERAS protocols is
expanding to encompass a wide range of surgical procedures, clinical scenarios,
healthcare institutions, and professional medical societies. In order to
maximize the effect by increasing adherence to ERAS, medical staff must fully
understand the clinical basis and meaning of each item, and the protocol must be
maintained and developed steadily through a team approach and audit system. |
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| ISSN: | 2234-2591 |