Enhanced Recovery After Surgery Symposium: Implementing Change and New Standard of Care in Surgery

Enhanced recovery after surgery (ERAS) programs aim to hasten functional recovery
and improve postoperative outcomes. ERAS programs are associated with shorter
length of hospital stay, a reduction in overall health care costs, and improvements in
patient satisfaction. The key to the success of an ERAS program involves preoperative,
intraoperative, and postoperative strategies including; pre-admission counseling,
avoidance of preoperative bowel preparation, use of opioid-sparing multimodal
perioperative analgesia (including loco-regional analgesia), intraoperative goal-directed
fluid therapy (GDT), and use of minimally invasive surgical techniques with avoidance
of routine use of nasogastric tube, drains and/or catheters. Postoperatively, it is
important to encourage early feeding, early mobilization, timely removal of tubes and
drains, if present, and function oriented multimodal analgesia regimens. Successful
implementation of an ERAS program requires a multidisciplinary team effort and active
participation of the patient in their goal-oriented functional recovery program.
There is a demand by the surgical community to learn how to implement ERAS
programs. The ERAS Gynecologic Oncology program has been extremely successful
in that since its initiation in 2014, a total of 1,227 patients have undergone surgery
and we have shown remarkable results including a 25% decrease in length of stay,
an 80% reduction in opioid consumption in the postoperative period, and a significant
improvement in Patient Reported Outcomes (PROs). There is a need to share this
information with our surgeon colleagues so that they can implement the same program
in their respective hospitals. The activity is designed to change the outcomes of patients
undergoing surgery and the expected outcome is to see the implementation of ERAS
programs in other centers with the goal of achieving a high level of compliance with all
items of the ERAS guidelines. This conference will also open opportunities for surgeons
to collaborate on future projects related to ERAS outcomes.