Enhanced Recovery in Colorectal Surgery: Are we Going Forward or Backward?_Crimson Publishers

Enhanced Recovery in Colorectal Surgery: Are we Going Forward or Backward? by Shantata J Kudchadkar and Jayesh Sagar* in Crimson Publishers: Open access journal of surgery impact factor

Enhanced Recovery (ERAS) in Colorectal Surgery is a relatively novel concept in patient care. It involves a multidisciplinary team approach (surgeons, anesthetists, ERAS nurse, nutritionist, physiotherapist, pain team, hospital administration and patient motivation) comprising of certain key aspects in the pre, intra and post-operative settings. The whole objective of ERAS pathway is to reduce the physiological trauma to the patient and optimize organ functions, thus leading to reduced pain, post-operative complications, faster patient recovery, improvement in overall outcome, shorter hospital stays and thus, accounting for decreased health-care costs. However, there is still a need for more patient-specific, better designed large-scale, multi-centre randomized trials to study long-term impact of ERAS. A valid primary research question still remains to be answered-whether it is reasonable to apply one standard fixed protocol to everyone or modify the ERAS care to an individual patient considering various other parameters such as patient characteristics and physiology, pre-existing co-morbidities, indication & type of surgery (emergency/elective) and compliance factors. Our aim is to highlight the importance of formulating a personalized ERAS program for certain high-risk patients, rather than adopting one rigid protocol for everyone.

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