Enhanced recovery after surgery in thoracic surgery: the past, the present and the future

Enhanced recovery after surgery (ERAS) is a multimodal plan of care based on the application of multiple standardized evidence-based elements and aimed at improving the perioperative patient experience, by accelerating recovery, reducing complications and shortening hospital stay. The multiple elements, which constitute the ERAS pathway cover all temporal domains of the perioperative care: preoperative, intraoperative and postoperative. They are based on the concept of marginal gains. The individual elements may have limited effect on the outcome when used in isolation but they act synergistically when applied in combination to reduce the surgical stress and hasten recovery (1).