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Enhanced Recovery After Surgery (ERAS) in the Oncologic Patient

  • Joshua BotdorfEmail author
  • Celia Robinson Ledet
  • Ninotchka Brydges
  • Danilo Lovinaria
  • Garry Brydges
Reference work entry

Abstract

Enhanced Recovery After Surgery (ERAS) is a term used to describe perioperative care protocols that have been demonstrated to improve patient outcomes after major oncologic surgery. In 2001, a group of academic surgeons invented ERAS with the goal of developing optimal perioperative pathways that will provide optimal care throughout the patient’s journey. Some authors use other terms such as enhanced recovery programs (ERP) or fast-track surgery. ERAS guidelines include a series of perioperative evidence-based interventions to maintain physiological function, enhance mobilization, minimize pain, and facilitate early oral nutrition postoperatively by reducing perioperative surgical stress. Further, the guidelines strive to attenuate the loss of functional capacity after surgery (Lassen et al. World J Surg. 2013;37:240–58). The adoption of ERAS will improve outcome as evidenced by morbidity rate reduction, faster recovery, and decrease length of hospital stay (Thorell et al. World J Surg. 2016;40:2065–83). The effectiveness of ERAS protocols has shown to be beneficial in the maintenance of homeostasis via controlling metabolism and fluid shifts, and the support of the return of key functions through early detection and rescue of symptom burden. The principles of ERAS are gaining ground and spreading into a range of different surgical specialties and procedures. The utilization of evidence-based ERAS protocols will minimize healthcare team’s practice variation resulting in patient engagement, timely quality recovery, safety, positive outcomes, and cost reduction. The chapter will describe the implications of ERAS pathways when caring for oncologic patients perioperatively through interdisciplinary approach. A key focus for critical care teams is to provide a comprehensive overview and targeted areas of care to implement interventions consistent with new healthcare delivery trends.

Keywords

Enhanced Recovery After Surgery (ERAS) Pathways Protocol Evidence based practice Perioperative Interprofessional Interdisciplinary Outcomes 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Joshua Botdorf
    • 1
    Email author
  • Celia Robinson Ledet
    • 2
  • Ninotchka Brydges
    • 5
  • Danilo Lovinaria
    • 3
  • Garry Brydges
    • 4
    • 6
  1. 1.Department of Critical Care and Respiratory Care, Division of Anesthesia, Critical Care and Pain MedicineThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Surgical OncologyThe University of Texas, MD Anderson Cancer CenterHoustonUSA
  3. 3.University of Minnesota Nurse Anesthesia ProgramMinneapolisUSA
  4. 4.Anesthesiology – CRNA SupportThe University of Texas MD Anderson Cancer CenterHoustonUSA
  5. 5.Department of Critical Care and Respiratory CareThe University of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.Division of Anesthesia, Critical Care and Pain Medicine, Department of AnesthesiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

Section editors and affiliations

  • Garry Brydges
    • 1
  1. 1.Division of Anesthesia, Critical Care and Pain Medicine, Department of AnesthesiologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

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