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 .
Prospective, randomized, controlled trial of thoracic epidural or patient-controlled opiate analgesia on perioperative quality of life.
BACKGROUND Perioperative epidural analgesia provides continuous pain control and may have advantages over parenteral opiate administration . This study assessed the impact of epidural analgesia on quality of life ( QOL ) of patients undergoing major surgery . METHODS Sixty patients undergoing thoracic or thoraco-abdominal surgery were studied prospect ively . Patients were r and omly assigned to receive either thoracic epidural analgesia or patient-controlled i.v . opiate analgesia ( PCA ) after operation .  Visual analogue pain and sedation scores were recorded for the period of the study . QOL health surveys at 24 h ( SF-8 acute form ) and at 1 week ( SF-36 ) were recorded . Results were examined by uni- and multivariate analyses corrected for the effect of multiple comparisons . RESULTS Mean pain scores were significantly lower in the epidural group at most time points . Physical and mental scores in the epidural group were significantly better than the PCA group for both SF-8 and SF-36 QOL health surveys ( P<0.001 ) . CONCLUSIONS Epidural analgesia with local anaesthetic and opioid improves QOL and delivers better analgesia compared with PCA in patients undergoing major thoraco-abdominal 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 .