Piler, Tomas and Schauer, Martin Ignaz and Larisch, Christopher and Riedel, Julia and Neu, Reiner and Hofmann, Hans-Stefan and Ried, Michael (2024) Priorities and strategy for the implementation of enhanced recovery after surgery (ERAS) in thoracic surgery. JOURNAL OF THORACIC DISEASE, 16 (7). pp. 4165-4173. ISSN 2072-1439, 2077-6624
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Background: Enhanced recovery after surgery (ERAS) is a perioperative care protocol, which was introduced several years ago and has gained increasing importance in thoracic surgery. The aim of this study was to provide guidance through clinical implementation and to identify factors for better compliance. Methods: This prospective cohort study collected data between July 2021 and June 2022 at the Department of Thoracic Surgery (University Hospital Regensburg, Germany). A modified enhanced recovery after thoracic surgery (ERATS) protocol with recommendations covering the pre-, intra- and postoperative phases was established and followed. The primary objective was to evaluate the implementation of the ERATS protocol. Secondary, specific and clinically relevant recommendations were analyzed regarding their compliance. Results: The study included 139 patients undergoing elective lung resections. Many ERATS recommendations were already part of standard perioperative care, including perioperative antibiotics, venous thromboembolism prophylaxis and intraoperative warming. Other measures such as anemia management, carbohydrate loading or chest drain management were updated or newly established and standardized according to our ERATS protocol. The recommendations emphasizing early postoperative mobilization were found to be crucial. We identified three groups with significantly different compliance rates: (I) patient-dependent measures which require active participation (49.3%); (II) treatment measures requiring interdisciplinary consensus (85.8%); and (III) surgical measures (88%). Conclusions: The implementation and continuous evaluation of our perioperative ERATS protocol led to a new categorization of targeted measures into three groups with actors of different competencies. The new grouping enables gradual implementation and a step-by-step targeted approach in order to achieve a higher compliance of ERATS in the future as well as long-term sustainability.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | LUNG-CANCER; OUTCOMES; Enhanced recovery after surgery (ERAS (R)); thoracic surgery; perioperative care; fast-track surgery |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Abteilung für Thoraxchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 13 Jan 2026 15:43 |
| Last Modified: | 13 Jan 2026 15:43 |
| URI: | https://pred.uni-regensburg.de/id/eprint/63935 |
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