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Manual of Fast Track Recovery for Colorectal Surgery pp 1–13Cite as

Overview: Key Elements and the Impact of Enhanced Recovery Care

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Part of the book series: Enhanced Recovery ((ER))

Abstract

Surgeons have had a long-standing interest in the immune and metabolic response to injury. Such interest has been spurred on by the recognition that modulation of these pathways might provide a route to reduce postoperative morbidity and mortality. Claude Bernard (France) first developed the concept of the milieu intérieur and Walter Cannon (USA) described the complex homeostatic responses involving the brain, nerves, heart, lungs, kidneys and spleen that work to maintain body constancy. Subsequently, Sir David Cuthbertson (UK) divided the metabolic response to injury into ebb, flow and recovery phases and quantified the amount and likely sources of protein breakdown following long bone fracture. Thereafter, individuals such as Francis Moore (USA) and Douglas Wilmore (USA) described in detail the response to injury in humans and methods of optimal nutritional and metabolic support. However, by the time of the second millennium the average length of hospital stay after colorectal abdominal surgery was still 10–15 days.

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Author information

Authors and Affiliations

  1. Department of Surgical Oncology, University of Edinburgh/Royal Infirmary, Edinburgh, UK

    Kenneth C. H. Fearon

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  1. Kenneth C. H. Fearon
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Editors and Affiliations

  1. Yeovil District Hospital NHS Foundation, Yeovil, BA21 4AT, United Kingdom

    Nader Francis

  2. St Mark's Hospital, Watford Road, Harrow, HA1 3UJ, United Kingdom

    Robin H. Kennedy

  3. Department of Surgery, Örebro University Hospital, Örebro, 701 85, Sweden

    Olle Ljungqvist

  4. University College of London, Centre for Anaesthesia, WC1E 6, United Kingdom

    Monty G. Mythen

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Fearon, K.C.H. (2012). Overview: Key Elements and the Impact of Enhanced Recovery Care. In: Francis, N., Kennedy, R., Ljungqvist, O., Mythen, M. (eds) Manual of Fast Track Recovery for Colorectal Surgery. Enhanced Recovery. Springer, London. https://doi.org/10.1007/978-0-85729-953-6_1

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