Enhanced Recovery After Surgery: Recommendations for Esophagectomy

Esophagectomy for malignant and benign disease has historically been associated with high rates of morbidity and mortality—a distinguishing feature of this complex surgery. The increasing adoption of enhanced recovery after surgery (ERAS) programs within esophageal surgery provides a framework within which standardized care can be delivered to patients with the intention of ensuring predictable high-quality outcomes. Presented herein is a summary of current evidence and recommendations for standardized perioperative care in esophagectomy. Recommendations are divided between preoperative, operative, and postoperative periods and address central issues concerning patient prehabilitation nutrition in addition to technical aspects of surgical and anesthetic management. The central role of the multidisciplinary team in setting appropriate goals and delivering a coordinate high standard of care is strongly emphasized.