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 .
Erythropoietin-alfa during neoadjuvant chemotherapy for locally advanced esophagogastric adenocarcinoma.
BACKGROUND In a previous study we showed that many patients with esophagogastric adenocarcinoma experience anemia during neoadjuvant chemotherapy . We now investigated the role of erythropoietin in managing anemia during neoadjuvant chemotherapy . METHODS Patients with esophagogastric adenocarcinoma who experienced anemia ( hemoglobin < 12 g/dL ) during neoadjuvant treatment  received  erythropoietin 10,000  IE subcutaneously three times a week . Primary outcomes were the response to erythropoietin , safety , the need for allogeneic red blood cell transfusion , and the rate of postoperative complications . RESULTS Between April 2003 and December 2004 , 24 patients ( median age , 62 years ) were enrolled . The mean hemoglobin level before chemotherapy was 12.5 g/dL and the mean hemoglobin level before patients received erythropoietin was 11.5 g/dL. One year after involvement in the trial , 4 of 17 analyzable patients were still anemic ( hemoglobin level < 12 mg/dL ) . Twenty-two patients received erythropoietin , and 16 ( 73 % ) responded . We could observe a significant increase in hemoglobin concentrations under therapy with erythropoietin to 12.6 g/dL ( p < 0.001 ) . Two patients ( 8 % ) received allogeneic transfusions ; the rate of postoperative complications was 16 % . There were no erythropoietin-related  adverse events . CONCLUSIONS Treatment with erythropoietin is effective and well tolerated in patients with esophagogastric adenocarcinoma who experience anemia during neoadjuvant chemotherapy
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 .