Enhanced recovery (ERAS) and perioperative nutrition
Instead of starving patients before and after an operation, modern surgical pathways feed them early, give carbohydrate drinks the night before, and get them walking the next day. Complications and hospital stays fall.
ERAS protocols bundle 20-plus evidence-based elements: no prolonged fasting, pre-operative carbohydrate loading, avoidance of routine nasogastric tubes and drains, early oral feeding, multimodal opioid-sparing analgesia and early mobilisation. Meta-analyses across colorectal, gastric, pancreatic and oesophageal surgery show 30-50% fewer complications and a two- to three-day shorter stay, with no increase in readmissions. Nutrition is the thread running through the bundle; malnourished patients (weight loss over 10%, low albumin) benefit from 7-14 days of pre-operative nutritional support, and this is the doorway through which prehabilitation entered surgical care.
How it works
Minimising the catabolic stress response to surgery through nutritional, anaesthetic and physiological measures preserves gut function and lean mass and shortens recovery.
- Large and consistent effect on complications and stay
- Low cost; mostly removing harmful habits
- Guidelines exist for every major cancer operation
- Compliance with all elements is often below 70%
- Effect on long-term oncological outcomes indirect
- Requires whole-team culture change
Latest papers
topQuery for this technology: (TITLE:"Enhanced recovery ERAS and perioperative nutrition" OR ABSTRACT:"Enhanced recovery ERAS and perioperative nutrition") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Enhanced recovery (ERAS) and perioperative nutrition, not a curated reading list.