Nari GA. Actualización sobre ERAS en la Revista Argenꢁna de Cirugía. Rev Argent Cir 2021;113(3):277-278
I was pleased to be invited to write an editorial of complicaꢁons, and a lower number of readmissions.
on ERAS (Enhanced Recovery Aꢀer Surgery), a topic The same conclusions were reached for colorectal
that has been extensively covered in the issue 113 (2) surgery by the group of Hospital Italiano and of the
of the current year.
U.K. . This last group emphasizes prehabilitaꢁon; we
This issue of the Journal has 6 papers on fully agree that -basically in cancer paꢁents- opꢁmizing
opꢁmized recovery, demonstraꢁng the relevance anemia, nutriꢁonal status and comorbidiꢁes is essenꢁal
that such programs have achieved worldwide, and to increase the success of each program. Mentz et al. .
the importance Argenꢁna gives to the maꢂer . The reported that adherence to all the items of the programs
ERAS Society endorses what has been stated above used reduces the number of length of hospital stay;
and nowadays sets the standards for this mulꢁmodal >60% of adherence results in a reducꢁon of 1.77 days
approach system through its recommendaꢁons .
in length of hospital stay when compared to paꢁents
Ljunqvist stated that, even though such managed with standard care. When adherence is > 70%,
recommendaꢁons exist, several groups with diﬀerent this reducꢁon is even greater. Another important issue
protocols obtain similar results; this is probably due is the percentage of paꢁents who achieve full recovery
to the fact that most of the protocols used have few at discharge because it is associated with the number
diﬀerences between them. Probably, the diﬀerences of readmissions and probably the long-term outcomes.
are due to the environments (public vs. private
Finally, as Bisch et al.4 stated, the aim of
hospital) and, in agreement with Edmonton, beyond implemenꢁng an ERAS program is to reduce costs for
the economic resources, resistance to change and the paꢁents by approximately CAD 1798 for each service
development of new capabiliꢁes may turn out to be provided. For this reason, and because it increases the
diꢄculꢁes to overcome in the conꢁnuous improvement producꢁvity of the insꢁtuꢁons (the decrease in length
of these programs . For Lillemoe , educaꢁng the paꢁent of hospital stay promotes an increase in the number of
and family, pain management and ﬂuid therapy are surgical services in a highly demanded system), ERAS
the cornerstones to construct an enhanced recovery has boomed and, as the Canadian authors pointed out,
Most publicaꢁons on surgeries in diﬀerent
its implementaꢁon should be considered a state policy.
In the current number, we present a review of
organs basically show a decrease in length of hospital the implementaꢁon of an enhanced recovery program
stay, a probable decrease in the number and severity (ERP) in liver surgery which we hope will be useful.
Referencias bibliográﬁcas /References
. Mc Loughlin S, Fraidenraij U, Álvarez AO. Opꢁmización
perioperatoria. Rev Argent Cir. 2021; 113(2):147-48.
Rev Argent Cir. 2021; 113(2):176-88.
. Ljungqvist O. La base cienꢃﬁca de los protocolos
ERAS®. Rev Argent Cir. 2021; 113(2):149-58.
6. Mentz RE, Campana JP, Fraidenraij U, Mata-Suarez SM,
Álvarez AO, Mc Loughlin S. Implementación de un programa
ERAS®. Rev Argent Cir. 2021; 113(2):189-96.
Mc Loughlin S, Fraidenraij U, Álvarez AO. Programas de
Opꢁmización Perioperatoria, Enhanced Recovery y Fast-track: ¿Por
qué están en auge? ¿Qué son realmente y cómo se implementan
en la prácꢁca? Rev Argent Cir. 2021; 113(2):159-68.
7. Melloul E, Hübner M, Scoꢂ M, Snowden C, Prenꢁs J, Dejong
CHC et al.
Guidelines for Perioperaꢁve Care for Liver
Surgery: Enhanced Recovery Aꢀer Surgery (ERAS) Society
Recommendaꢁons. World J Surg. 2016; 40(10):2425-40.
. Bisch SP, Gramlich L, Nelson G. Aplicación del programa ERAS®
como una políꢁca de salud pública en el sistema de salud de
Alberta, Canadá. Rev Argent Cir. 2021; 113(2):169-75.
8. Lillemoe HA, Aloia TA. Enhanced Recovery Aꢀer Surgery:
Hepatobiliary. Surg Clin North Am. 2018; 98(6):1251-64.
. William Maclean, Paul Mackenzie, Chris Limb, Timothy