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 .
Goal-Directed Fluid Therapy Using Stroke Volume Variation Does Not Result in Pulmonary Fluid Overload in Thoracic Surgery Requiring One-Lung Ventilation
Background . Goal -directed fluid therapy ( GDT ) guided by functional parameters of preload , such as stroke volume variation ( SVV ) , seems to optimize hemodynamics and possibly improves clinical outcome . However , this strategy is believed to be rather fluid aggressive , and , furthermore , during surgery requiring thoracotomy , the ability of SVV to predict volume responsiveness has raised some controversy . So far it is not known whether GDT is associated with pulmonary fluid overload and a deleterious reduction in pulmonary function in thoracic surgery requiring one-lung-ventilation ( OLV ) . Therefore , we assessed the perioperative course of extravascular lung water index ( EVLWI ) and paO2/FiO2-ratio during and after thoracic surgery requiring lateral thoracotomy and OLV to evaluate the hypothesis that fluid therapy guided by SVV results in pulmonary fluid overload . Methods . A total of 27 patients ( group T ) were enrolled in this prospect i ve study with 11 patients undergoing lung surgery ( group L ) and 16 patients undergoing esophagectomy ( group E ) .  Goal -directed fluid management was guided by SVV ( SVV < 10 % ) . Measurements were performed directly after induction of anesthesia ( baseline — BL ) , 15 minutes after implementation OLV ( OLVimpl15 ) , and 15 minutes after termination of OLV ( OLVterm15 ) . In addition , postoperative measurements were performed at 6 ( 6postop ) , 12 ( 12postop ) , and 24 ( 24postop ) hours after surgery . EVLWI was measured at all predefined steps . The paO2/FiO2-ratio was determined at each point during mechanical ventilation ( group L : BL-OLVterm15 ; group E : BL-24postop ) . Results . In all patients ( group T ) , there was no significant change ( P > 0.05 ) in EVLWI during the observation period ( BL : 7.8 ± 2.5 , 24postop : 8.1 ± 2.4 mL/kg ) . A subgroup analysis for group L and group E also did not reveal significant changes of EVLWI . The paO2/FiO2-ratio decreased significantly during the observation period ( group L : BL : 462 ± 140 , OLVterm15 : 338 ± 112 mmHg ; group E : BL : 389 ± 101 , 24postop : 303 ± 74 mmHg ) but remained > 300 mmHg except during OLV . Conclusions . SVV-guided fluid management in thoracic surgery requiring lateral thoracotomy and one-lung ventilation does not result in pulmonary fluid overload . Although oxygenation was reduced , pulmonary function remained within a clinical ly acceptable range
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 .