Enhanced Recovery After Surgery (Eras) In Gi Surgery: Evidence And Implementation
Keywords:
Enhanced Recovery After Surgery, Gastrointestinal Surgery, ERAS Implementation, Perioperative Care, Postoperative RecoveryAbstract
Enhanced Recovery After Surgery (ERAS) represents a paradigm shift in perioperative care, integrating evidence-based, multidisciplinary strategies designed to optimize surgical outcomes and accelerate patient recovery. Originally developed for colorectal procedures, ERAS protocols have since been adapted to various gastrointestinal (GI) surgeries, including esophagectomy, gastrectomy, and hepatopancreatobiliary (HPB) operations. These protocols focus on minimizing surgical stress, maintaining physiological balance, and promoting early mobilization, oral intake, and patient engagement. Implementation across different phases preoperative, intraoperative, and postoperative has been shown to reduce postoperative morbidity, hospital stay, and overall healthcare costs without compromising safety or oncological outcomes. Globally, ERAS has achieved high compliance and institutional acceptance through structured training, continuous audits, and multidisciplinary teamwork. In India, while the adoption of ERAS principles is growing, challenges such as limited resources, inconsistent compliance, and resistance to traditional practices remain significant barriers. Nonetheless, successful outcomes from tertiary centers highlight its potential for broader application. Future directions involve digital integration, individualized recovery pathways, and expansion into resource-limited settings. Continued research is needed to address regional variations, strengthen evidence on long-term outcomes, and establish national guidelines for standardized implementation. ERAS has redefined the postoperative recovery process, offering a patient-centered, efficient, and sustainable model for modern surgical care in gastrointestinal practice..
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