Table 2.
Summary of ERAS elements
| Period | ERAS items | Teixeira40 | Jing23 | Ding21 | Ma31 | Thornblade41 | Qi35 | Liang28 | Kaibori et al.26 | Ovaere33 | Sutherasan39 | Joliat24 | Page34 | Clark18 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pre-op | Preoperative education | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | X | ✓ | ✓ | ✓ |
| Preoperative nutrition | ✓ | x | ✓ | X | ✓ | ✓ | ✓ | X | X | X | X | X | X | |
| No preanesthetic medication | ✓ | X | X | ✓ | X | x | X | ✓ | X | X | X | X | X | |
| No bowel preparation | ✓ | ✓ | X | ✓ | X | ✓ | ✓ | ✓ | X | ✓ | ✓ | X | ✓ | |
| Minimal pre-op fasting | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | ✓ | X | |
| Carbohydrate drinks 2 h before surgery | ✓ | X | X | ✓ | ✓ | ✓ | ✓ | Up to 3 h prior to surgery | ✓ | X | ✓ | ✓ | X | |
| Thromboembolism prophylaxis | ✓ | X | X | X | ✓ | ✓ | ✓ | X | X | X | ✓ | X | ✓ | |
| Intra-op | Thoracic epidural anaesthesia | ✓ | ✓ | X | ✓ | X | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | X |
| Antibiotic prophylaxis | ✓ | X | X | ✓ | ✓ | X | X | X | ✓ | X | ✓ | X | X | |
| Short-acting anaesthetic agent | ✓ | X | X | X | X | X | ✓ | ✓ | ✓ | X | X | X | X | |
| Avoid excessive i.v. fluids | ✓ | ✓ | X | X | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | ✓ | ✓ | |
| No routine use of NG tubes | ✓ | X | ✓ | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| No routine use of abdominal drain | ✓ | ✓ | X | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| Prevention of hypothermia | ✓ | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | ✓ | x | X | |
| Post-op | Removal of urinary catheter | X | ✓ | POD 1 | X | X | 12 h post-op | POD 1 | POD 3 | POD 1 | POD 2 | POD 3 | x | POD 1 |
| Removal of abdominal drains | X | POD 2–3 | X | POD 2 | X | ✓ | <POD3 | x | POD 2 | x | X | X | x | |
| Post-op laxatives | X | X | X | X | X | X | X | X | X | X | ✓ | X | X | |
| Restart water intake | POD 1 | POD 1 | 6 h post-op | POD 1 | POD 0 | 6 h post-op | 6 h post-op | POD1 | X | X | 4 h post-op | x | POD 0 | |
| Restart normal diet | POD 1 | ✓ | POD 1 | POD 3 | POD 1 | POD 1 | POD 1 | POD 1 | POD 1 | POD 1 | POD 1 | x | POD 0 | |
| Early mobilization | ✓ | ✓ | POD 1 | POD 1 | POD 1 | POD 1 | POD 1 | POD1 | POD 0 | X | POD 0 | X | POD O | |
| Oral analgesia | X | X | X | X | POD 2 | X | POD 3 | POD 1 | X | X | X | X | POD 0 | |
| Ileus prevention | X | X | X | ✓ | POD 1 | X | X | X | X | X | X | X | X | |
| Glycaemic control | ✓ | X | X | X | ✓ | X | X | X | X | X | X | X | X | |
| Prevention of PONV | ✓ | X | X | X | X | X | ✓ | X | X | X | ✓ | X | ✓ | |
| Reduction of IV fluids | ✓ | X | POD 1 | POD 1 | POD 1 | X | POD 0 | POD 1 | X | X | POD 1 | x | POD 1 | |
| Systemic audit | ✓ | X | X | X | X | X | ✓ | X | X | X | ✓ | X | X | |
| Period | ERAS items | Liang29 | Labgaa27 | Savikko37 | He22 | Dasari19 | Day et al.20 | Zhu et al.42 | Ni32 | Jones25 | Sánchez-Pérez36 | Lin30 | Stoot38 | Van Dam2 |
| Pre-op | Preoperative education | ✓ | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | ✓ | ✓ |
| Preoperative nutrition | ✓ | X | X | X | X | X | X | X | ✓ | X | X | X | X | |
| No preanesthetic medication | X | X | X | X | ✓ | X | X | ✓ | ✓ | X | ✓ | ✓ | ✓ | |
| No bowel preparation | ✓ | ✓ | X | X | X | ✓ | ✓ | ✓ | ✓ | X | ✓ | X | X | |
| Minimal pre-op fasting | ✓ | ✓ | X | ✓ | ✓ | ✓ | X | ✓ | ✓ | X | ✓ | ✓ | ✓ | |
| Carbohydrate drinks 2 h before surgery | ✓ | ✓ | ✓ | ✓ | ✓ | x | X | ✓ | ✓ | X | ✓ | ✓ | ✓ | |
| Thromboembolism prophylaxis | X | ✓ | X | X | ✓ | X | X | X | ✓ | X | ✓ | X | x | |
| Intra-op | Thoracic epidural anaesthesia | X | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | ✓ | X | ✓ | ✓ | ✓ |
| Antibiotic prophylaxis | ✓ | ✓ | X | ✓ | ✓ | X | X | X | ✓ | X | ✓ | X | X | |
| Short-acting anaesthetic agent | X | X | X | ✓ | X | X | X | X | X | X | X | ✓ | ✓ | |
| Avoid excessive i.v. fluids | ✓ | ✓ | X | ✓ | X | ✓ | X | ✓ | ✓ | ✓ | X | ✓ | ✓ | |
| No routine use of NG tubes | ✓ | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| No routine use of abdominal drain | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | X | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | |
| Prevention of hypothermia | ✓ | ✓ | X | ✓ | ✓ | X | X | X | ✓ | X | X | X | ✓ | |
| Post-op | Removal of urinary catheter | POD 1 | POD 1 | POD 2–3 | POD 1 | POD 2 | X | X | POD 2 | POD 2 | X | POD 1 | ✓ | POD 3 |
| Removal of abdominal drains | POD 2 | N/A | POD 1 | X | N/A | x | POD 3 | POD 2 | POD 2 | 24–48 h post-op | N/A | N/A | N/A | |
| Post-op laxatives | X | ✓ | ✓ | ✓ | X | X | X | POD 1 | X | X | X | X | X | |
| Restart water intake | 6 h post-op | 4 h post-op | POD 0 | 4 h post-op | POD 1 | POD 0 | POD 1 | POD 1 | POD 0 | 6–8 h post-op | 6 h post-op | POD 1 | POD 0 | |
| Restart normal diet | POD 1 | POD 1 | POD 0 | 12 h post-op | POD 1 | POD 1 | POD 1 | POD 3 | POD 0 | X | 6 h post-op | ✓ | POD 1 | |
| Early mobilization | POD 1 | POD 1 | POD 0 | POD 1 | Full mobilization POD 3 | POD 1 | POD 1 | POD 1 | POD 1 | 6–8 h post-op | POD 1 | ✓ | POD 1 | |
| Oral analgesia | POD 2 | POD 3 | POD 0 | X | POD 1 | POD 1 | POD 4 | X | POD 2 | POD 2 | POD 4 | X | POD 1 | |
| Ileus prevention | X | X | X | X | X | X | X | X | X | X | X | X | X | |
| Glycaemic control | X | X | X | ✓ | X | X | X | X | ✓ | X | X | X | x | |
| Prevention of PONV | X | ✓ | X | ✓ | ✓ | ✓ | X | x | ✓ | X | X | X | x | |
| Reduction of IV fluids | POD 0 | POD 1 | X | POD 2 | POD 1 | x | POD 1 | x | POD 1 | X | POD 1 | X | POD 1 | |
| Systemic audit | X | ✓ | X | X | X | ✓ | X | X | X | x | X | X | x |