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 .
Optimal duration of urinary catheterization after thoracotomy in patients under postoperative patient-controlled epidural analgesia.
BACKGROUND Epidural analgesia is widely used for efficient pain relief after major surgery . However , it may cause urinary retention , leading to delayed removal of bladder catheters with prolonged patient discomfort . Using a specific regimen in patient controlled epidural analgesia ( PCEA ) , we examined the optimal duration of urinary catheterization in patients undergoing major thoracic surgery . METHODS Seventy-eight patients scheduled for elective thoracotomy  were prospect ively r and omized into two groups : Group 1 , removal of the transurethral catheter on the first postoperative day ( n = 38 ) ; Group 2 , removal of the catheter after discontinuation of PCEA ( n = 40 ) . The PCEA regimen was a mixture containing low-dose morphine , bupivacaine and neostigmine and was given for 3 days after surgery in all subjects . Micturition problems , pain scores assessed by the visual analog scale ( VAS ) , and side effects were evaluated during and after PCEA treatment . RESULTS The average duration of urinary drainage after surgery was 30.2 + or - 5.1 hours and 78.5 + or - 7.3 hours in Groups 1 and 2 , respectively . After removal of the bladder catheter , no patient in either group required re-catheterization for urinary retention or encountered catheter-related infection . VAS scores were significantly lower in Group 1 at rest and at 24 , 36 and 48 hours after cessation of PCEA . VAS scores were significantly higher in Group 2 patients , possibly due to catheter-induced pain related to prolonged catheterization . CONCLUSION Routine continuous bladder catheterization may not necessarily be required after thoracotomy in patients with ongoing continuous thoracic epidural analgesia
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 .