Enhanced Recovery After Surgery

Olle Ljungqvist, MD, PhDProfessor of Surgery, Senior Consultant SurgeonDepartment of SurgeryÖrebro University and Örebro University HospitalÖrebro, Sweden, 70185olle.ljungqvist@ki.se Nader K. Francis, MBChB, FRCS, PhDProfessorConsultant Colorectal SurgeonDepartment of SurgeryYeovil District Hospital NHS Foundation TrustHigher KingstonYeovil, Somerset, UK, BA21 4ATnader.francis@ydh.nhs.uk Richard D. Urman, MD, MBA, FASAAssociate Professor of AnesthesiaDepartment of Anesthesiology, Perioperative and Pain MedicineHarvard Medical SchoolBrigham and Women’s HospitalBoston, Massachusetts, USAurmanr@gmail.com

• I. Introduction.- 1. Enhanced Recovery After Surgery: A Paradigm Shift in Perioperative Care.- 2. Physiology and Pathophysiology of ERAS.- 3. Guidelines for Guidelines.- II.  Preoperative Preparation.- 4. Preoperative Fasting and Carbohydrate Treatment.- 5. Preoperative Patient Education.- 6. Perioperative Optimization of Patient Nutritional Status.- 7. Anemia and Blood Management.- 8. Perioperative Smoking and Alcohol Cessation.- 9. Preoperative Medical Optimization.- 10. Prehabilitation.- 11. Cognitive Behavior Counseling – Preoperative Preparation in ERAS.- 12. Bowel Preparation: Always, Sometimes, Never? .- 13. Pharmacogenomics in Perioperative Care.- III. Intraoperative Management.- 14. Anesthetic Management and the Role of the Anesthesiologist in Reducing Surgical Stress and Improving Recovery.- 15. Analgesia During Surgery (Medications).- Chapter 16. Regional Anesthesia Techniques for Abdominal Operations.- Chapter 17. Prevention of Intraoperative Hypothermia.- Chapter 18. Perioperative Intravenous Fluid Therapy in ERAS Pathways.- Chapter 19. ERAS and Minimally Invasive Surgical Techniques.- Chapter 20. Tubes and Drains: Current Updates on Evidence on Their Role Within Recovery.- IV. Postoperative Management.- Chapter 21. Management of Postoperative Nausea and Vomiting (PONV) .- Chapter 22. Early Oral Nutrition.- 23. Early Ambulation and Physiotherapy After Surgery.- 24. Postoperative Multimodal Pain Management.- 25. Nursing Considerations During Patient Recovery.- V. Prevention of Postoperative Complications.- 26. Long-Term Outcomes Related to ERAS.- 27. Postoperative Ileus: Prevention and Treatment.- 28. Antibiotic Prophylaxis and Surgical Site Infection Prevention.- 29. Thromboprophylaxis.- VI. ERAS After Discharge.- 30. Functional Recovery at Home and After Discharge.- 31. Recovery Within the Cancer Journey.- 32. Readmission Challenges and Impacts Within ERAS.- 33. An Example of a Patient’s Experience in ERAS.- VII. Safety and Quality Improvementin ERAS.- Measuring Outcomes in ERAS.- 35. Measurement of Recovery Within ERAS.- 36. Measuring Compliance: Audit and Data Collection.- 37. Success and Failure of ERAS: Prediction Models of Outcomes.- 38. Research Methods in Enhanced Recovery After Surgery.- 39. Toward a Learning System for ERAS: Embedding Implementation and Learning Evaluation.- VIII. Specialty-Specific Enhanced Recovery Programs.- 40. ERAS in Colorectal Surgery.- 41. Enhanced Recovery After Surgery: Recommendations for Esophagectomy.- 42. Enhanced Recovery After Gastrectomy.- 43. Bariatric Surgery.- 44. ERAS for Major Urological Procedures: Evidence Synthesis and Recommendations.- 45. ERAS for Breast Reconstruction.- 46. Gynecologic/Oncology Surgery.- 47. Enhanced Recovery After Surgery: Cesarean Delivery.- 48. ERAS in Spine Surgery.- 49. Orthopedic Surgery in Enhanced Recovery After Surgery.- 50. ERAS in Otolaryngology – Head and Neck Surgery.- 51. Cardiac Surgery ERAS.- 52. Vascular Surgery and ERAS.- 53. Thoracic Surgery.- 54. Enhanced Recovery Program in the Ambulatory Surgery Setting.- 55. Enhanced Recovery After Surgery: Emergency Laparotomy.- 56. Liver Surgery.- 57. Pancreatic Surgery.- 58. Pediatric Enhanced Recovery After Surgery.- IX. Administrative.- 59. Department-wide Implementation of an Enhanced Recovery Pathway: Barriers and Facilitators.- 60. Introducing Enhanced Recovery Programs into Practice: Lessons Learned from the ERAS® Society Implementation Program.- 61. Enhanced Recovery After Surgery – Making the Business Case: Economics – The Alberta Experience.- 62. ERAS® Society and Latin American.- 63. ERAS® Society and Asia.- 64. ERAS for Low- and Middle-Income Countries.- 65. ERAS Position in the Global Surgical Community.