Table II.

Enhanced recovery after surgery protocol compared with standard care protocol

Variable	Standard care	Enhanced Recovery After Surgery Protocol
Before admission	Surgical and anaesthesia consultation Perioperative risk assessment Admission 1 day before surgery	Surgical and anaesthesia consultation Perioperative risk assessment Patient education including ERAS principles, treatment goals, discharge criteria and expected length of stay Smoking cessation Prehabilitation (30 min walks 2 weeks prior to surgery) Admission 1 day before surgery
Before surgery	Mechanical oral bowel preparation (Fortrans or Citrafleet) Clear fluids up to 8 h before surgery Antibiotic prophylaxis (preoperative cefuroxime 1.5 g + metronidazole 0.5 g i.v. 30–60 min prior to surgery)	No bowel preparation (excluding rectal resection with total mesorectal excision (TME) Solid meals up to 6 h and clear fluids up to 2 h before surgery Preoperative carbohydrate loading (400 ml of Nutricia preop. 2 h before surgery) Antibiotic prophylaxis (preoperative cefuroxime 1.5 g + metronidazole 0.5 g i.v. 30–60 min prior to surgery) Deep vein thrombosis (DVT) prophylaxis (clexane 40 mg s.c. starting in the evening prior to surgery)
Perioperatively	Open surgery (longitudinal incision) or laparoscopic approach (longitudinal minilaparotomy for specimen extraction) Non-balanced intravenous fluid therapy (2500–4500 ml intravenous crystalloids during the day of surgery – amount decided by anaesthetist and surgeon) Peritoneal drainage after each type of surgery Avoidance of prophylactic nasogastric tubes Anti-emetics according to instructions given by anaesthetist	Laparoscopic surgery (transverse minilaparotomy for specimen extraction) Balanced intravenous fluid therapy (< 2500 ml intravenous fluids during the day of surgery, sodium restriction) Avoidance of prophylactic nasogastric tubes and drains Postoperative nausea and vomiting prophylaxis (8 mg dexamethasone i.v., ondansetron 8 mg i.v.)
Postoperatively	Analgesia decided by anaesthetist and surgeon Introduction of clear fluids on 2nd postoperative day Introduction of oral diet on 3rd postoperative day DVT prophylaxis (Clexane 40 mg s.c. starting on the 1st postoperative day) Mobilization on the 2nd day after surgery Removal of urinary catheter when patient fully mobilized	Non-opioid multimodal analgesia Transversus abdominis plane block Introduction of clear fluids 2 h after return to ward Oral nutritional supplement in the evening on the day of surgery (Nutricia Nutridrink) Postoperative oxygenation therapy Introduction of oral diet on 1st postoperative day Early mobilization 2 h after return to ward Early removal of urinary catheters (< 24 h postoperatively)
Discharge	Discharge at surgeon's decision when indicated clinically	Discharge after fulfilling discharge criteria
After discharge	7 day follow-up in outpatient clinic	Telephone call on the 1st and 3rd day after discharge 7 day follow-up in outpatient clinic