This volume presents a comprehensive, up to date and practical approach to creating an ERAS program for GI surgery. The first sections review the evidence underlying individual elements of ERAS, including evidence from laparoscopic procedures when available or pointing to evidence gaps where more research is required. These are written by experts in the field, including surgeons, anesthesiologists, nurses, and physiotherapists. The format is in the style of a narrative review, with narrative evidence review, and concluding with a table with take home messages and 3-5 key references for readers interested in more depth in each topic. Each chapter also addresses management of common complications and patient selection or exceptions. Subsequent chapters address practical concerns, including creation of a pathway team, project management and engaging administration. Experts contribute real-world examples of their pathways for a variety of procedures, including colorectal surgery, bariatric surgery, upper GI and hepatobiliary surgery, enabling the user to have a starting point for creating their own programs.

The SAGES Manual of Enhanced Recovery Programs for Gastrointestinal Surgerywill be of great value to fully trained surgeons, anesthesiologists, nurses and administrators interested in initiating an ERAS program.

Liane S. Feldman

McGill University Health Centre

Division of General Surgery

Montreal, Quebec

Canada

Conor P. Delaney, MD MCh PhD FRCSI FACS FASCRS

University Hospitals Case Medical Center

Case Western Reserve University

Division of Colorectal Surgery

Cleveland, OH
USA

Olle Ljungqvist, MD, PhD

Orebro University Hospital

Department of Surgery

Örebro

Sweden

Francesco Carli, MD MPhil, FRCA

Department of Anesthesia

McGill University Health Centre

Montreal, Quebec

Canada

Introduction to Enhanced Recovery Programs: A Paradigm Shift in Perioperative Care.- Section I: The Science of Enhanced Recovery: Building Blocks for your Program.- Preoperative Education.- Medical Optimization and Prehabilitation.- Preoperative Fasting and Carbohydrate Treatment.- Bowel Preparation: Always, Sometimes, Never?.- The Role of the Anesthesiologist in Reducing Surgical Stress and Improving Recovery.- Prevention of Hypothermia.- Prevention of Postoperative Nausea and Vomiting.- Thromboprophylaxis.- Surgical Site Infection Prevention.- Fluid Management.- Postoperative Ileus: Prevention and Treatment.- Choosing Analgesia to Facilitate Recovery.- Early Nutrition and Early Mobilization: Why They Are Important and How to Make it Happen.- Management of Tubes, Drains, and Catheters.- Hospital Recovery and Full Recovery.- Section II: Creation and Implementation of an Enhanced Recovery Program.- Overcoming Barriers to the Implementation of an Enhanced Recovery After Surgery Program.- Introducing Enhanced Recovery Programs into Practice: Lessons Learned from The ERAS® Society Implementation Program.- Enhanced Recovery Programs: Making the Business Case.- Audit: Why and How.- Why Add an ERP to a Laparoscopic Case: The Colorectal Experience.- Section III: Examples of Enhanced Recovery Programs.- Enhanced Recovery Programs for Colorectal Surgery: University Hospitals Case Medical Center.- Enhanced Recovery Programs for Colorectal Surgery: The Guilford: (UK) Experience.- Setting up an Enhanced Recovery Program Pathway for Bariatric Surgery: Current Evidence into Practice.- Enhanced Recovery Pathways in Hepato-pancreato-biliary Surgery.- Enhanced Recovery Programs for Upper Gastrointestinal Surgery: How I Do It.- Department-Wide Implementation of an Enhanced Recovery Pathway.- The ERAS® Society.- SAGES SMART Enhanced Recovery Program.