Abstract
Enhanced Recovery after Surgery (ERAS) pathways have become popular in colorectal
surgery due to their associated decrease in length of stay (LOS), complications, and
readmission rate. However, it is unclear if these pathways are safe, feasible, or
effective in unique patient populations such as elderly patients, urgent/emergent
surgeries, patients with specific comorbidities, inflammatory bowel disease, or pediatric
patients. Enhanced recovery pathways appear safe in elderly patients, associated with
decreased complications, though with slightly lower rates of adherence and increased
LOS and readmission rates. Modified ERAS pathways have been applied to urgent and
emergent surgeries, resulting in decreased morbidity and LOS. There have been no studies
that performed subgroup analyses of ERAS pathways in patients with specific comorbidities.
Studies investigating patients with inflammatory bowel disease on enhanced recovery
pathways are extremely limited, but suggest that they are safe and feasible. Data
on ERAS pathways in pediatric patients are still emerging. Therefore, though data
are sparse, enhanced recovery pathways appear to be safe in unique patient populations,
with similar efficacy in decreasing LOS and complications. There is an urgent need
for more studies investigating these specific patient groups to aid perioperative
decision making by colorectal surgeons.
Keywords
ERAS - enhanced recovery - elderly - urgent - pediatric
