Table 2.
Reported intervention components of the ERP
| 20 Components (defined according to ERAS® Society guidelines 2012 [3, 4]) | Zeng 2017 [16] | Pirrera 2017 [17] | Forsmo 2017 [18] | Braga 2017 [19] | Braga 2016 [20] | Gonzalez-Ayora 2016 [21] | Pedziwiatr 2015 [22] | Kisialeuski 2015 [23] | Jia 2014 [24] | Keller 2013 [25] | Feroci 2013 [26] | Baek 2013 [27] | Wang 2012 [28] | Pawa 2012 [29] | Walter 2011 [30] | Kahokehr 2011 [31] | Rumstadt 2009 [32] | Hendry 2009 [33] | Scharfenberg 2007 [34] | Senagore 2003 [35] | Bardram 2000 [36] | Total per ERP component (median = 13.5) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1. Pre-operative counselling | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 18 |
| 2. Pre-operative optimisation | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 |
| 3. Avoidance of bowel preparation in colonic surgery | 1 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 0 | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 12 |
| 4a. Limited pre-operative fasting time | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 1 | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 16 |
| 4b. Carbohydrate loading | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | |
| 5. Avoid sedative premedication | 0 | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 5 |
| 6. Prophylaxis against thromboembolism | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 11 |
| 7. Antimicrobial prophylaxis | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 1 | 13 |
| 8. Standard anaesthetic protocol1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 15 |
| 9. PONV prophylaxis/treatment | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 0 | 0 | 0 | 8 |
| 10. Laparoscopy and modifications of surgical acces2 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 0 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 0 | 1 | 1 | 14 |
| 11. Avoidance of nasogastric tubes | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 21 |
| 12. Prevention intra-operative hypothermia | 0 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 1 | 1 | 1 | 0 | 1 | 0 | 0 | 0 | 11 |
| 13. Peri-operative fluid management | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 17 |
| 14. Avoid abdominal or pelvic drains | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 1 | 1 | 1 | 0 | 0 | 0 | 0 | 13 |
| 15. Early removal of urinary catheters | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 21 |
| 16. Prevention of post-operative ileus3 | 0 | 1 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 1 | 1 | 1 | 0 | 0 | 7 |
| 17. Opioid sparing multimodal post-operative analgesia | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 21 |
| 18. Early oral intake | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 21 |
| 19. Peri-operative glycaemic control | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 20. Early mobilisation | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 21 |
| Total ERP components per article (median = 13) | 11 | 15 | 16 | 16 | 16 | 14 | 15 | 16 | 8 | 10 | 15 | 13 | 10 | 14 | 13 | 13 | 13 | 14 | 10 | 7 | 10 |
LEGEND: 0 = not reported as a component of the ERP; 1 = reported as a component of the ERP; ERP: enhanced recovery programme; PONV: post-operative nausea and vomiting; 1based on the regional anaesthesia technique (0: no/inadequate information, epidural anaesthesia as a routine procedure for laparoscopic surgery in studies that started including after 2012; 1: epidural anaesthesia for all patients, except for patients undergoing laparoscopic surgery after 2012); 2automatically score 1 if only laparoscopic patients were included in the study; 3chewing gum or laxatives or Alvimopan