Enhanced recovery after surgery in gastric resections

• Published in: Cirugia Española Vol. 95; no. 2; p. 73
• Main Authors: Bruna Esteban, Marcos, Vorwald, Peter, Ortega Lucea, Sonia, Ramírez Rodríguez, Jose Manuel
• Format: Journal Article
• Language: English
• Published: Spain 01.02.2017
• Subjects: Clinical Protocols; Female; Gastrectomy - rehabilitation; Humans; Male; Patient Care Team; Cirugía gástrica; Rehabilitación multimodal; Recuperación intensificada; Enhanced recovery after surgery; Gastric surgery; Fast-track
• ISSN: 1578-147X
• DOI: 10.1016/j.ciresp.2016.10.013

Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery. The measures to be applied are divided in a preoperative, perioperative and postoperative stage. This document provides recommendations concerning the appropriate information, limited fasting and administration of carbohydrate drinks 2hours before surgery, specialized anesthetic strategies, minimal invasive surgery, no routine use of drainages and tubes, mobilization and early oral tolerance during the immediate postoperative period, as well as criteria for discharge. The application of a protocol of enhanced recovery after surgery in resective gastric surgery can improve and accelerate the functional recovery of our patients, requiring an appropriate multidisciplinary coordination, the evaluation of obtained results with the application of these measures and the investigation of controversial topics about which we currently have limited evidence.