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 .
Results of a prospective algorithm to remove chest tubes after pulmonary resection with high output.
OBJECTIVE Many patients have their hospital discharge delayed because their chest tube drainage is too high , despite the fact that there are no data to support the commonly used 250 mL/day threshold . METHODS A retrospective cohort study was conducted with a prospect i ve data base and prospect i ve algorithm from one surgeon . All patients underwent elective pulmonary resection .  The last chest tube was removed if there was no air leak and nonchylous drainage of 450 mL/day or less . RESULTS The study comprised 8608 operations and 2077 patients who underwent an elective ( nonpneumonectomy ) pulmonary resection via thoracotomy by one general thoracic surgeon over a 10-year period . Eighty-nine patients went home with a chest tube owing to air leak . The remaining 1988 patients were discharged without a chest tube . Types of pulmonary resection were wedge resection in 729 patients , segmentectomy in 214 , lobectomy in 1104 , and bilobectomy in 30 . The median day of discharge was postoperative day 4 . One hundred one ( 5 % ) were readmitted to the hospital within 60 days of discharge . The most common reason for readmission was dehydration and fatigue . Only 11 ( 0.55 % ) had readmissions owing to recurrent symptomatic effusion and most were treated with video-assisted thoracoscopy . Follow-up was 100 % at 4 weeks and 93 % at 8 weeks . CONCLUSIONS Chest tubes can be removed with up to 450 mL/day of nonchylous drainage after pulmonary resection , and perhaps a higher volume could be accepted . Readmission owing to a recurrent effusion is exceedingly uncommon , and the practice of leaving the tube in longer for drainage less than 450 mL/day is unsupported in the literature
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 .