Editorial Open Access
A Piece of Mind on Enhanced Recovery after Surgery
Zhong Jia1*, Yue Zhou2 and Jie Ni3
1,2,3 Hangzhou First People’s Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, China.
*Corresponding author:

Dr. Zhong Jia, Department of Hepato pancreato bililiary, Surgery, Huansha RoadNo.261, Hangzhou First People’s Hospital, Nanjing Medical University Affiliated Hangzhou Hospital, Hangzhou, Zhejiang 310006, China. Fax:+86-0571-87914773; Mobile phone:+86-13958114181; E-mail: @

Received: December 18, 2017; Accepted: December 29, 2017; Published: January 08, 2018
Citation: Citation: Zhong Jia, Yue Zhou, et al. (2018) A Piece of Mind on Enhanced Recovery after Surgery. SOJ Surgery 5(1): 1-1. DOI: http://dx.doi.org/10.15226/2376-4570/5/1/00150
Enhanced Recovery After Surgery (ERAS) has become a spotlight around the world [1]. It aims to accelerate patients’ recovery after surgery and prioritize the cost-effectiveness of medical cost. Generally, multiple disciplinary work teams are of crucial import ancestor make an optimized protocol in detail. Also it is accordance with the top principle of precision medicine in clinical practice. However, minimally invasive surgery and shortening length of stay in hospital have been excessive emphasized or over evaluated as a foremost target to seek for, which is pushing some patients in to risk of worsing outcomes. Some of patients havet of acere admission due to serious post operative complications or insufficient nutrition due to discharge ahead. Hence, it’s time to correct the misunderstanding of ERAS and rethought about it. Obviously, the right understanding of ERAS is of essence to benefit both of surgeons and patients.

How to obtain better understanding of ERAS? Authors propose a concept of 4-Stoclarify the truly implication of ERAS.

• Survival: Micro invasive surgery really does matter to ERAS, but not be-all, especially for patients with malignancy. Improvement of survival rate should be the top priority of ERAS.

• Safe: Multiple Disciplinary Team (MDT) aims to provide an accessible protocol to ensure patients’ safety per operation [2]. High End surgery must be in accordance with operators’ experience and their accurate skill. It is not practical to establish a standardized ERAS to meet the demand of different levels of primary clinical settings.

No one doubts that smart medical service combined with skillful surgery is bringing ERAS on precision medicine track [2,3]. ERAS is not only a concept, but also of relevance for hospital’s management. Obviously, improvement of ERAS is a long-term work, steps such as supervision should be taken into something so that it runs in good order.

• Saving: As we all well known, it’s essential to save total medical cost because of scarce health-care resources. As a result, the length of stay in hospital is shortened because of application of high-end equipments or smart ecosystem including laparoscopic or robotic surgery, mobile smart wrist device, etc. However, smart medical service may also increase the burden of patients’ medical cost or transfer the cost to the provider. How to balance the new emerging techniques and the traditional techniques means save.

• Standardization of evaluation system: The days of stay in hospital, total hospitalization cost, post operative complications, the frequency of reoperation {post operative time less than 3months) and/or read mission(less than 1 month after discharge), survival time (more than 6 months), the severity of surgery-related negative emotion, etc play a deciding role in judging/evaluating ERAS whether successful or not. At first glance, no discomfort of painperi operation and perfect surgery are important elements of ERAS, but on second look, the pain curbed by drugs may hides mistruth. As a matter of fact, it is unreliable to predict anything.
All authors declare that they have no any conflicts of interests on the manuscript.
  1. LauCS, Chamberlain RS. Enhanced Recovery After Surgery Programs Improve Patient Outcomes and Recovery: A Meta-analysis. World J Surg. 2016;41(4):899-913. doi:10.1007/s00268-016-3807-4
  2. Nelson G, Kiyang LN, Chuck A, Thanh NX, Gramlich LM. Cost impact analysis of Enhanced Recovery After Surgery program implementation in Alberta colon cancer patients. Curr Oncol. 2016;23(3):e221-e227. doi:10.3747/co.23.2980.
  3. SolaM, Ramm CJ, Kolarczyk LM, Teeter EG, Yeung M, Caranasos TG, Vavalle JP. Application of a Multidisciplinary Enhanced Recovery after Surgery Pathway to Improve Patient Outcomes after Transcatheter Aortic Valve Implantation. Am J Cardiol. 2016;118(3):418-423. doi:10.1016/j.amjcard.2016.05.015.
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