Table 1. Enhanced recovery after surgery (ERAS) protocol.

Time point	Protocol
On admission	1. Preoperative health education 2. No smoking or alcohol 3. Preoperative physical examination to assess nutritional status and rule out contraindications to surgery
Day before surgery	1. No routine bowel preparation (except in case of constipation) 2. Oral administration of 1000 mL of 10% glucose solution at 10 PM on the night before surgery, with another 300 mL at 6 AM the next morning (replaced by saline in patients with diabetes) 3. No solid food 6 h before surgery, and no oral fluids 2 h before surgery 4. Anesthesia consultation, skin preparation, blood examination, insertion of indwelling gastric tube and urinary catheter, and prophylactic antibiotics
Day of surgery	1. General anesthesia alone or in combination with thoracic epidural anesthesia 2. Electric blanket and abdominal-temperature saline irrigation to maintain body temperature during surgery 3. Decision to use abdominal drainage tubes depended on the surgical conditions 4. Intravenous infusion of fluid, calculated as 15–20 mL/kg + volume of blood loss during surgery 5. Subcutaneous infiltration anesthesia + intravenous/epidural analgesic pump anesthesia + intravenous nonsteroidal anti-inflammatory drug (e.g., 50 mg flurbiprofen) + 100 mg tramadol orally 6. Attempt to drink warm water (∼50 mL/h) 6 h after surgery 7. Routine prevention of nausea and vomiting for 2–3 days
Postoperative day 1	1. Early mobilization encouraged 2. Oral fluid intake increased to 500 mL, intravenous fluid volume reduced, total caloric intake limited to 25–30 kcal/kg per day 3. Gastric tube removed according to accepted criteria for extubationa 4. Intermittent urinary catheterization started to train the bladder and stopped when bladder sensation returned to normal 5. Oral lactulose administered for 2 days (in general) and stopped after passing of flatus 6. Chewing gum to stimulate return of normal gastrointestinal function
Postoperative day 2	1. Encouragement to continue and prolong out-of-bed activities 2. Oral fluid intake increased to 1000 mL, liquid diet (such as small amounts of rice soup) started, intravenous fluids reduced so that total intake was unaffected 3. Antibiotics stopped if there was no evidence of infection 4. Gastric tube removed if not obstructeda 5. If urinary catheter was not obstructed, it was removed after completion of bladder training
Postoperative day 3	1. Encouragement to continue and prolong out-of-bed activities 2. Oral fluid intake gradually increased to 1500 mL gradually, amount of liquid diet increased, intravenous fluid volume gradually reduced so that total intake remained the same 3. Abdominal drainage tube removedb after evaluation for 2 days
Postoperative day 4	1. Encouragement to continue and prolong out-of-bed activities 2. Frequent small amounts of oral fluids, small amounts of semi-liquid foods (porridge, noodles, or other soft foods), intravenous fluids stopped if possible, and oral intake increased to maintain the total intake
Postoperative day 5 to discharge	1. Encouragement to continue and prolong out-of-bed activities 2. Frequent small amounts of oral fluids, with gradual transition to total semi-liquid diet and soft foods; amount of total intake amount maintained

^aThe gastric tube could be removed when the amount of drainage was <100 mL/d; the drained fluid was not blood-tinged, and flatus had been passed. ^bThe abdominal drainage tube could be removed when abdominal infection, anastomotic fistula, and other postoperative complications were ruled out, and the drainage volume was <10 mL/d for 2 days.