The SAGES ERAS Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery PDF

The SAGES ERAS Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery PDF



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Preface

Two major changes have improved outcomes in elective surgery: the introduction of minimally invasive surgery (MIS) revolutionized abdominal surgery, significantly lessening the impact of major surgery, reducing complications, and accelerating recovery. For many surgeons, interest in laparoscopic techniques was fueled by this desire to improve outcomes, especially recovery after surgery. There is a limit, however, to what can be accomplished using surgical techniques alone, and factors that keep people hospitalized and delay their return to normal functioning are multiple and complex. These include the surgical stress response, pain, postoperative nausea and vomiting, limited mobility, fluid overload, fatigue, and deconditioning, even in the absence of surgical complications. Enhanced Recovery After Surgery (ERAS) pathways are coordinated, multidisciplinary care plans incorporating evidence- based interventions along the entire perioperative trajectory and represent the second major step to improved outcomes after surgery. Traditionally, surgeons, anesthesiologists, and nurses have delivered care from individual silos. ERAS pathways represent a paradigm shift from traditional care, instead integrating multiple individual elements of perioperative care from these stakeholders, as well as empowering patients and caregivers to better understand the recovery process. By leveraging the gains achieved by MIS techniques with ERAS pathways, the goal is to further improve recovery, decrease complications, and decrease variability in practice, which in turn will be reflected in shorter hospital stay, lower costs, and improved patient satisfaction improving value for surgical procedures.
The SAGES / ERAS Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery represents a collaboration between two societies committed to improving surgical outcomes, from two unique but overlapping perspectives. SAGES has promoted the introduction and expansion of minimally invasive surgery, while the ERAS Society was created to promote implementation of evidence-based perioperative care. Both societies aim to improve patient recovery, decrease morbidity, and educate others in proven techniques and interventions.


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