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World J Gastroenterol. Oct 28, 2012; 18(40): 5661-5663
Published online Oct 28, 2012. doi: 10.3748/wjg.v18.i40.5661
Published online Oct 28, 2012. doi: 10.3748/wjg.v18.i40.5661
Enhanced recovery programme in colorectal surgery: Does one size fit all?
Alison Lyon, Specialty Registrar in General Surgery, West of Scotland Rotation, Glasgow G4 0SF, United Kingdom
Christopher J Payne, Graham J MacKay, Lister Department of Surgery, Glasgow Royal Infirmary, Glasgow G4 0SF, United Kingdom
Author contributions: Lyon A acted as first author of the paper; Payne CJ helped research, write and edit the paper; MacKay GJ set the framework and performed the final edit of the paper.
Correspondence to: Graham J MacKay, MBChB, FRCS, MD, Consultant Colorectal Surgeon, Honorary Senior Lecturer, Lister Department of Surgery, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, United Kingdom. drgjmac@hotmail.com
Telephone: +44-141-2320852 Fax: +44-141-2114880
Received: August 26, 2011
Revised: March 24, 2012
Accepted: April 22, 2012
Published online: October 28, 2012
Revised: March 24, 2012
Accepted: April 22, 2012
Published online: October 28, 2012
Abstract
Enhanced recovery after surgery (ERAS) employs a multimodal perioperative care pathway with the aim of attenuating the stress response to surgery and accelerating recovery. It has been difficult to determine the relative importance of some of the individual components of these pathways such as epidural analgesia and laparoscopic colorectal surgery. Some argue that only a rigid adherence to the published ERAS protocol can achieve the proposed benefits of fast-track surgery. In this article, we explore some of the areas where the evidence base may be changing and ask whether a more flexible and individualised approach should be considered.