Enhanced recovery after surgery protocol: impact on postoperative recovery and complications
DOI:
https://doi.org/10.18203/2349-2902.isj20261574Keywords:
ERAS protocol, Postoperative recovery, Postoperative complications, Perioperative care, Length of hospital stayAbstract
The enhanced recovery after surgery (ERAS) protocol consists of a set of multimodal strategies aimed at optimizing perioperative care, with the goal of reducing the surgical stress response and improving postoperative outcomes. In this systematic review, it was observed that the implementation of ERAS reduces length of hospital stay, decreases postoperative complications, and reduces opioid use. However, the benefits were less evident in patients with greater clinical severity or those undergoing more invasive surgeries. Thus, the ERAS protocol appears to be effective in optimizing surgical recovery, especially when there is high adherence and individualized care.
Metrics
References
Çetin B, Çilesiz NC, Ozkan A, Onuk Ö, Kır G, Balci MBC, et al. Enhanced Recovery After Surgery (ERAS) Reduces Hospital Costs and Length of Hospital Stay in Radical Cystectomy: A Prospective Randomized Controlled Study. Cureus. 2024;16(3):e55460. DOI: https://doi.org/10.7759/cureus.55460
Jain SN, Lamture Y, Krishna M. Enhanced Recovery After Surgery: Exploring the Advances and Strategies. Cureus. 2023;15(10):e47237. DOI: https://doi.org/10.7759/cureus.47237
Mithany RH, Daniel N, Shahid MH, Aslam S, Abdelmaseeh M, Gerges F, et al. Revolutionizing Surgical Care: The Power of Enhanced Recovery After Surgery (ERAS). Cureus. 2023;15(11):e48795. DOI: https://doi.org/10.7759/cureus.48795
Gao B, Chen J, Liu Y, Hu S, Wang R, Peng F, et al. Efficacy and safety of enhanced recovery after surgery protocol on minimally invasive bariatric surgery: a meta-analysis. Int J Surg. 2023;109(4):1015-28. DOI: https://doi.org/10.1097/JS9.0000000000000372
Han H, Wan R, Chen J, Fan X, Zhang L. Effects of the enhanced recovery after surgery (ERAS) protocol on the postoperative stress state and short-term complications in elderly patients with colorectal cancer. Cancer Rep (Hoboken). 2024;7(2):e1979. DOI: https://doi.org/10.1002/cnr2.1979
Muetterties CE, Taylor JM, Kaeding DE, Morales RR, Nguyen AV, Kwan L, et al. Enhanced Recovery after Surgery Protocol Decreases Length of Stay and Postoperative Narcotic Use in Microvascular Breast Reconstruction. Plast Reconstr Surg Glob Open. 2023;11(12):e5444. DOI: https://doi.org/10.1097/GOX.0000000000005444
Geroin C, Weindelmayer J, Camozzi S, Leone B, Turolo C, Bencivenga M, et al. Association between ERAS protocol and major postoperative complications and reasons for non-compliance in patients with esophageal cancer. Eur J Surg Oncol. 2025;51(5):109707. DOI: https://doi.org/10.1016/j.ejso.2025.109707
Iqbal A, Rehman HU, Ahmad I, Bibi S, Safdar H, Ali L, et al. Optimizing postoperative outcomes: assessing the effect of enhanced recovery after surgery (ERAS) protocols in general surgical patients. J Ayub Med Coll Abbottabad. 2024;36(2):359-63. DOI: https://doi.org/10.55519/JAMC-02-13470
M Íximo MA, Santos D, F Lix-Oliveira A, Pereira M, Carmona C. Association between enhanced recovery after surgery protocol compliance and clinical complications: a cohort study. Braz J Anesthesiol. 2023;73(1):25-35. DOI: https://doi.org/10.1016/j.bjane.2021.08.018
Liao R, Li JC, Chen J, Wei XF, Yan X. A clinical observational study on the application of enhanced recovery after laparoscopic pancreaticoduo-denectomy. Front Surg. 2022;9:961161. DOI: https://doi.org/10.3389/fsurg.2022.961161
Rafeeqi T, Pearson EG. Enhanced recovery after surgery in children. Transl Gastroenterol Hepatol. 2021;6:46. DOI: https://doi.org/10.21037/tgh-20-188
Soni AK. Impact of ERAS protocol on postoperative recovery and complications in patients undergoing laparoscopic cholecystectomy: a prospective comparative analysis. J Pharm Bioallied Sci. 2025;17:S2265-7. DOI: https://doi.org/10.4103/jpbs.jpbs_920_25
Turaga AH. Enhanced recovery after surgery (ERAS) protocols for improving outcomes for patients undergoing major colorectal surgery. Cureus. 2023;15(7):e41755. DOI: https://doi.org/10.7759/cureus.41755
Katikam SM, Komari LK, Parimi SBR. Evaluation of Enhanced Recovery After Surgery (ERAS) Protocols in Abdominal Surgery. J Pharm Bioallied Sci. 2025;17:S1805-7. DOI: https://doi.org/10.4103/jpbs.jpbs_1900_24
Rasilainen S, Tiainen T, Pakarinen M, Bumblyte V, Scheinin T, Schramko A. ERAS failure and major complications in elective colon surgery: Common risk factors. Surg Pract Sci. 2022;10:100080. DOI: https://doi.org/10.1016/j.sipas.2022.100080
Ștefănescu VC, Ionescu AM, Florea SF, Vasile MA, Bătăilă V, Cochior D. Impact of Enhanced Recovery after Surgery Program Implementation. Our Results. Chirurgia (Bucur). 2025;120(2):159-68. DOI: https://doi.org/10.21614/chirurgia.3118
Mohamed Y, Hussein A, Elsaba O, Rhodes M, Alloush K, Elhofy E, et al. Optimizing Postoperative Outcomes in Abdominal Surgery: The Role of Enhanced Recovery After Surgery (ERAS) Protocols. Cureus. 2025;17(2):e79258. DOI: https://doi.org/10.7759/cureus.79258
Parthsarthi PA, Agrawal AA, Parmar A, Manish M, Arora I, Kumari M. Enhanced recovery after surgery (ERAS) protocols: Impact on patient outcomes. Bioinformation. 2025;21(10):3599-602. DOI: https://doi.org/10.6026/973206300213599
Ștefănescu VC, Ionescu AM, Florea SF, Vasile MA, Bătăilă V, Cochior D. Breaking surgical barriers: ERAS in action in Romania. J Med Life. 2025;18(3):229-34. DOI: https://doi.org/10.25122/jml-2025-0034
Song JH, Kim M. Clinical outcomes and future directions of enhanced recovery after surgery in colorectal surgery: a narrative review. Ewha Med J. 2024;47(4):e69. DOI: https://doi.org/10.12771/emj.2024.e69