Enhanced recovery after surgery protocols in gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for gastric cancer

Gastric cancer with peritoneal carcinomatosis (PC) remains a formidable challenge in oncological care, especially regarding surgical intervention. Integrating enhanced recovery after surgery (ERAS) protocols into gastrectomy with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy has emerged as a promising approach. This minireview explores the influence of ERAS on surgical and oncological outcomes in this multifaceted procedure. Recent evidence suggests that ERAS, comprising multimodal strategies, improves postoperative recovery, reduces complications, and enhances quality of life. It may also contribute to better survival outcomes by minimizing perioperative morbidity and thereby facilitating the timely initiation of adjuvant therapy. Mechanistically, ERAS promotes early mobilization, attenuates postoperative immunosuppression, and supports timely adjuvant therapies, which are crucial in managing carcinomatosis. This minireview underscores the importance of multidisciplinary collaboration and individualized patient care to maximize ERAS benefits. Large-scale, prospective investigations are warranted to validate these findings and refine ERAS protocols for this specialized patient cohort. Further research will facilitate ongoing advancements in oncological surgery and perioperative care, ultimately improving outcomes for patients with gastric cancer and PC.