Enhanced Recovery After Surgery Pathway: How its Implementation Influenced Digestive Surgery Outcomes?

Introduction: In recent years, enhanced recovery after surgery protocols have increasingly been integrated into perioperative care of patients undergoing digestive surgery. Aims: To conduct a non-systematic literature review related to the integration of enhanced recovery after surgery protocols in elective gastrectomy, colonic and rectal surgery, and the impact this had on outcomes. Methods: The PubMed database was searched to identify studies that focused on the integration of enhanced recovery after surgery protocols in clinical practice, as well as their outcomes. 37 studies fulfilled the inclusion criteria and were reviewed accordingly between the years of 2007 and 2017. Results: The enhanced recovery after surgery pathway has shown to reduce time to return of bowel function and to minimize length of hospital stay by at least one day, when compared to conventional care, in colorectal surgery and gastrectomy for gastric cancer. Optimal results are achieved with maximum compliance rates. Conclusions: The enhanced recovery after surgery protocols may be safely implemented in colorectal surgery and gastrectomy for gastric cancer, producing improved patient outcomes. An adequate integration of the enhanced recovery after surgery protocols in these areas, with a high compliance rate, is a step towards a faster return of patients to their baseline activity.