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 .
Psychiatric morbidity among patients with cancer of the esophagus or the gastro-esophageal junction: a prospective, longitudinal evaluation.
Cancer of the esophagus is often diagnosed at a late stage and is related to severe morbidity and a low 5-year survival rate . Previous studies have reported low health-related quality of life and high suicide rates for these patients . The occurrence of psychiatric morbidity and thus the potential need for psychological support may vary over time after diagnosis . This has not been adequately studied in patients with newly diagnosed cancer of the esophagus or gastro-esophageal junction . The present study therefore aim ed to prospect ively evaluate the prevalence of psychiatric morbidity in 94 consecutive patients ( median age 66 , range 45 - 88 years ) with all stages of disease .  Psychiatric morbidity was evaluated with the  Hospital Anxiety and Depression Scale ( HADS ) question naire at inclusion and 1 , 2 , 3 , 6 and 12 months later . At inclusion , 42 % of the patients had HADS scores indicating possible or probable anxiety disorder and /or depression . At all follow-ups except at 3 months , proportions of patients with possible/probable anxiety disorder were significantly lower than at inclusion . Among patients with a duration of tumor-specific symptoms exceeding 6 months pre-diagnosis , larger proportions of patients with a possible/probable anxiety disorder were found at the 1- and 6-month follow ups . The prevalence of possible/probable depression was greater among patients treated with a palliative intent than among those with a curative intent at inclusion . Patients who died during the study period scored worse for depression compared to the survivors . Apart from this , the proportion of patients with possible/probable psychiatric morbidity ( anxiety and /or depression ) was relatively stable over time and was unrelated to patient characteristics or clinical background , including the treatment regime . In conclusion , psychiatric morbidity is common among esophageal cancer patients , both at inclusion and over time , regardless of the cancer therapy given . The findings stress the importance of monitoring the patients ' mental health and of offering adequate psychological care when needed
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 .