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 .
Enteral versus parenteral nutrition after oesophagogastric surgery: a prospective randomized comparison.
BACKGROUND There appears to be an emerging consensus that early postoperative nutritional support benefits the high-risk patient by decreasing septic morbidity , maintaining immunocompetence and improving wound healing .  Enteral nutrition via a feeding jejunostomy has been associated with serious complications , with a reported mortality rate as high as 10 % , while total parenteral nutrition has also been associated with a wide variety of complications . METHODS Ninety-seven patients undergoing oesophagectomy or gastrectomy underwent pre-operative nutritional assessment and were r and omized to receive either total parenteral nutrition ( 47 patients ) or enteral nutrition ( 50 patients ) . RESULTS There was no significant difference in the number of catheter-related complications between the two groups , but 9 ( 45 % ) patients in the total parenteral nutrition group had major morbidity ( potentially fatal in two patients ) requiring active intervention . CONCLUSIONS This study demonstrates enteral nutrition to be safe and associated with mainly reversible minor complications . It is probable that immediate postoperative enteral feeding conserves the gut 's integrity . Whether this leads to a reduction in postoperative septic complications has not been demonstrated by this study although there appears to be a trend in this direction , supporting the concept of enteral feeding as ' primary therapy ' . This can be safely , simply and economically achieved using a feeding jejunostomy placed at the time of surgery
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 .