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 .
Early postoperative jejunostomy feeding with an immune modulating diet in patients undergoing resectional surgery for upper gastrointestinal cancer: a prospective, randomized, controlled, double-blind study.
BACKGROUND The provision of perioperative immune modulating enteral feeds after major surgery may result in reduced infective complications , but meta-analyses have not demonstrated a survival advantage . The aim of this study was to determine whether early postoperative immune modulating jejunostomy feeding results in reduced infective complications in patients undergoing resectional surgery for upper gastrointestinal cancer . METHODS A total of 120 patients undergoing resection for cancers of the pancreas , oesophagus and stomach were r and omized in a double-blind manner to receive jejunostomy feeding with an immune modulating diet ( Stresson-Group A ) or an isonitrogenous , isocaloric feed ( 1250 Calories and 75 g protein/l -- Nutrison High Protein-Group B ) for 10 - 15 days . Feeding was commenced 4h postoperatively and continued for 20 h/day . The target volume ( ml/h ) was 25 on day 0 , 50 on day 1 , and 75 thereafter . Outcome measures included complications , hospital stay and mortality . RESULTS A total of 108 patients ( 54 in each group ) were analysed .  Feed delivery , although less than targeted , was similar in both groups . There were 6 ( 11 % ) deaths in each group . Median ( IQR ) postoperative hospital stay was 14.5 ( 12 - 23 ) days in Group A and 17.5 ( 13 - 23 ) days in Group B ( P=0.48 ) . A total of 24 ( 44 % ) patients in each group had infective complications ( P=1.0 ) . A total of 21 ( 39 % ) patients in Group A and 28 ( 52 % ) in Group B had non-infective complications ( P=0.18 ) . Jejunostomy-related complications occurred in 26 ( 48 % ) patients in Group A and 30 ( 56 % ) in Group B ( P=0.3 ) . CONCLUSION Early postoperative feeding with an immune modulating diet conferred no outcome advantage when compared with a st and ard feed
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 .