Overall , there is little direct evidence for components of ERAS , with much derived from nonesophageal thoracoabdominal surgery .
ERAS in principle seems logical and safe for esophagectomy .
OBJECTIVE This article aims to provide the first systematic review of enhanced recovery after surgery ( ERAS ) programs for  esophagectomy  and generate guidelines .
BACKGROUND ERAS programs use multimodal approaches to reduce complications and accelerate recovery .
Although ERAS is well established in colorectal surgery , experience after esophagectomy has been minimal .
However , esophagectomy remains an extremely high-risk operation , commonly performed in patients with significant comorbidities .
Consequently , ERAS may have a significant role to play in improving outcomes .
No guidelines or review s have been published in esophagectomy .
Pre-operative oral iron supplementation reduces blood transfusion in colorectal surgery - a prospective, randomised, controlled trial.
INTRODUCTION Allogeneic blood transfusion confers a risk to the recipient . Recent trials in colorectal surgery have shown that the most significant factors predicting blood transfusion are pre-operative haemoglobin , operative blood loss and presence of a transfusion protocol . We report a r and omised , controlled trial of oral ferrous sulphate 200 mg TDS for 2 weeks ' pre-operatively versus no iron therapy . PATIENTS AND METHODS Patients diagnosed with colorectal cancer were recruited from out-patient clinic and haematological parameters assessed . R and omisation was co-ordinated via a telephone r and omisation centre . RESULTS Of the 49 patients recruited , 45 underwent colorectal resection . There were no differences between those patients not receiving iron ( n = 23 ) and the iron-supplemented group ( n = 22 ) for haemoglobin at recruitment , operative blood loss , operation duration or length of hospital stay . At admission to hospital , the iron-supplemented group had a higher haemoglobin than the non-iron treated group ( mean haemoglobin concentration 13.1 g/dl [ range , 9.6 - 17 g/dl ] versus 11.8 g/dl [ range , 7.8 - 14.7 g/dl ] ; P = 0.040 ; 95 % CI 0.26 - 0.97 ) and were less likely to require operative blood transfusion ( mean 0 U [ range , 0 - 4 U ] versus 2 U [ range , 0 - 11 U ] transfused ; P = 0.031 ; 95 % CI 0.13 - 2.59 ) . This represented a cost reduction of 66 % ( 47 U of blood = pound4700 versus oral FeSO(4 ) at pound30 + 15 U blood at pound1500 ) . At admission , ferritin in the iron-treated group had risen significantly from 40 microg/l ( range , 15 - 222 microg/l ) to 73 microg/l ( range , 27 - 386 microg/l ; P = 0.0036 ; 95 % CI 46.53 - 10.57 ) . CONCLUSIONS Oral ferrous sulphate given pre-operatively in patients undergoing colorectal surgery offers a simple , inexpensive method of reducing blood transfusions
Overall , there is little direct evidence for components of ERAS , with much derived from nonesophageal thoracoabdominal surgery .
ERAS in principle seems logical and safe for esophagectomy .
OBJECTIVE This article aims to provide the first systematic review of enhanced recovery after surgery ( ERAS ) programs for  esophagectomy  and generate guidelines .
BACKGROUND ERAS programs use multimodal approaches to reduce complications and accelerate recovery .
Although ERAS is well established in colorectal surgery , experience after esophagectomy has been minimal .
However , esophagectomy remains an extremely high-risk operation , commonly performed in patients with significant comorbidities .
Consequently , ERAS may have a significant role to play in improving outcomes .
No guidelines or review s have been published in esophagectomy .