‘Enhanced recovery after surgery’ for gastrointestinal surgery: Quo vadimus?

Traditionally, certain mesaures such as perioperative fasting, mechanical bowel preparation, use of nasogastric tubes, drains, graduated diet, and prolonged bed rest were deemed essential for healing and recovery after surgery. Developments in the field of anesthesia such as regional anesthetic techniques and use of minimally invasive surgical techniques in the 1990s led to questions regarding need for these traditional principles of perioperative care. Triggered by the question, “Why is this patient in the hospital today?” Professor Henrik Kehlet initiated the pioneering work that later developed as enhanced recovery after surgery (ERAS) protocols.[1] ERAS is an evidence‐based multimodal approach that aims at hastening the patients’ recovery by attenuating the stress response by a continuum of preoperative, intraoperative, and postoperative interventions, which leads to accelerated recovery. It has also been unfortunately referred to as “Fast Track Surgery,” a name which may be misunderstood as a process of increasing the patient transit through the health‐care system for economic reasons, whereas in point of fact it aims at improving both the speed and quality of the patients’ recovery.