# Enhanced recovery after colorectal cancer surgery (ERAS pathway for bowel resection)

Source: https://onco.cc/protocols/enhanced-recovery-after-colorectal-surgery/  
OnCo record `enhanced-recovery-after-colorectal-surgery` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Enhanced recovery is a package of care for bowel cancer surgery: getting fitter and better nourished beforehand, a sugary drink up to two hours before, antibiotic tablets with the bowel preparation, two anti-sickness drugs, no routine tubes or drains, the urinary catheter out the next day, and eating and walking from the day after the operation.

## Summary

The current ERAS Society colorectal guideline (2025) could not be read: no abstract is indexed and the publisher refused a script. The most recent graded guideline that could be read in full is the 2024 Korean ERAS guideline for colorectal cancer (13 GRADE recommendations). Strong, high-quality: dexamethasone plus a 5-HT3 antagonist rather than either alone for nausea. Conditional for, high quality: oral antibiotics with mechanical bowel preparation. Conditional for, moderate: prehabilitation; preoperative oral nutritional supplements; carbohydrate loading up to 2 hours before; goal-directed fluid therapy in high-risk patients; TAP block; preoperative pharmacological thromboprophylaxis; urinary catheter out on day 1; early feeding and walking from day 1. Conditional against: routine intra-abdominal drain (moderate) and nasogastric tube (low). NICE NG180 offers an enhanced recovery programme to everyone having elective major surgery. On bowel preparation the bodies differ: WHO (2018) and the Korean guideline support oral antibiotics with mechanical preparation; NICE NG125 (recommendation from 2008) says not to use mechanical bowel preparation routinely to reduce infection; EUPEMEN does not recommend mechanical preparation alone.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: ERAS colorectal; ERAS bowel surgery; enhanced recovery colectomy; fast-track colorectal surgery; perioperative care for bowel cancer surgery

## Connected records

- protocols: [Blood clot prevention around cancer surgery, including extended prophylaxis after major abdominal and pelvic operations](https://onco.cc/protocols/vte-prophylaxis-after-cancer-surgery/), [Enhanced recovery after gynaecological cancer surgery (ERAS pathway for gynaecologic oncology)](https://onco.cc/protocols/enhanced-recovery-after-gynaecological-cancer-surgery/), [Enhanced recovery after liver surgery (ERAS pathway for hepatectomy)](https://onco.cc/protocols/enhanced-recovery-after-liver-surgery/), [Enhanced recovery after radical cystectomy (ERAS pathway for bladder removal)](https://onco.cc/protocols/enhanced-recovery-after-radical-cystectomy/), [Routine tests before planned surgery, by size of operation and fitness](https://onco.cc/protocols/routine-preoperative-tests/), [Surgical site infection prevention: skin preparation, antibiotic timing, warming and wound care](https://onco.cc/protocols/surgical-site-infection-prevention/)
- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/), [Rectal cancer](https://onco.cc/cancers/rectal-cancer/)
- technologies: [Enhanced recovery (ERAS) and perioperative nutrition](https://onco.cc/technologies/eras-perioperative-nutrition/), [Prehabilitation before cancer surgery](https://onco.cc/technologies/prehabilitation/)
- drugs: [Dexamethasone](https://onco.cc/drugs/dexamethasone/), [Ondansetron](https://onco.cc/drugs/ondansetron/)
- terms: [Colectomy](https://onco.cc/terms/colectomy/), [Prehabilitation (the pre-treatment window)](https://onco.cc/terms/prehabilitation-term/), [Total mesorectal excision (TME)](https://onco.cc/terms/total-mesorectal-excision/)
- ideas: [Clear drinks until two hours before an operation, rather than nothing from midnight](https://onco.cc/ideas/idea-pu-shorter-fasting-before-surgery/), [Enhanced recovery after cancer surgery, with each element's compliance measured and fed back](https://onco.cc/ideas/idea-pu-enhanced-recovery-with-measured-compliance/)

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