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 .
Volume Threshold for Chest Tube Removal: A Randomized Controlled Trial
Abstract : Background : Despite importance of chest tube insertion in chest trauma , there is no general agreement on the level of daily volume drainage from chest tube . This study was conducted to compare the effectiveness and safety of chest tube removal at the levels of 150 ml/day and 200 ml/day . Methods : Eligible patients ( 138 ) who needed replacement of chest tube ( because of trauma or malignancy ) were r and omized into two groups ; control ( removal of chest tube when drainage reached to 150 ml/day ) and trial ( removal of chest tube at the level of 200 ml/day ) . All patients received st and ard care during hospital admission and a follow-up visit after 7days of discharge from hospital . Patients were then compared in terms of major clinical outcomes using chisquared and t-test . Results : From the total of 138 patients , 70 and 68 patients were r and omized to control ( G150 ) and trial ( G200 ) group , respectively . Baseline characteristics were comparable between the two groups . Although the trial group had a shorter mean for length of hospital stay ( LOS ) ( 4.1 compared to 4.8 , p=0.04 ) , their differences in drainage time did not reach to the level of statistical significance ( p=0.1 ) . Analysis of data showed no statistically significant differences between the rate of radiological reaccumulation , thoracentesis and decrease in pulmonary sounds ( auscultatory ) , one week after discharge from hospital . Conclusions : Compared to a daily volume drainage of 150 ml , removal of chest tube when there is 200 ml/day is safe and will even result in a shorter hospital stay . This in turn leads to a lower cost
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 .