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 .
The effects of immediate enteral feeding with a formula containing high levels of omega-3 fatty acids in patients after surgery for esophageal cancer.
BACKGROUND We investigated whether supplementation of enteral nutrition ( EN ) with omega-3 polyunsaturated acids ( PUFAs ) affected platelet aggregation , coagulation activity , and inflammatory response in the early stages after esophageal cancer surgery . METHODS Twenty-eight patients with esophageal cancer who underwent the same surgical procedure were selected for this study . All patients received EN , which was started immediately after the operation and was increased to a maximum volume of 1500 ml/day by the third postoperative day ( POD ) . Eleven patients received a conventional EN formula ( Ensure Liquid ) , while the remaining 17 patients received a different formula rich in omega-3 PUFAs ( Racol [ RAC ] ) . Several markers of coagulation and fibrinolysis were determined in POD 2 , while the concentrations of interleukin (IL)-6 , IL-8 , 6-keto-PGF1alpha and thromboxane B2 were determined on PODs 1 , 3 , and 5 . RESULTS A total of 27 patients completed the study , 11 in the Ensure Liquid group and 16 in the RAC group . Administration of RAC significantly inhibited the postoperative decrease in platelet count . The level of D-dimer was attenuated significantly in the RAC group . Plasma IL-8 levels were decreased significantly in the RAC group on PODs 1 and 3 . The anti-inflammatory effects of omega-3 PUFAs were confirmed by the clinical findings of lower body temperature . The plasma concentration of 6-keto-PFG1alpha also tended to decrease in the RAC group with a significant difference on POD 5 . CONCLUSIONS Early EN with a large amount of omega-3 PUFAs in reduced platelet aggregation , coagulation activity , and cytokine production . All these effects would be expected to be beneficial in patients following esophageal cancer surgery . The clinical significance of the changes in eicosanoid production remains to be established
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 .